Provider Demographics
NPI:1750183513
Name:GIBBENS, SHAWN NATHANIEL
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:NATHANIEL
Last Name:GIBBENS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 AVENUE J
Mailing Address - Street 2:
Mailing Address - City:COZAD
Mailing Address - State:NE
Mailing Address - Zip Code:69130-1708
Mailing Address - Country:US
Mailing Address - Phone:308-784-4222
Mailing Address - Fax:
Practice Address - Street 1:821 AVENUE J
Practice Address - Street 2:
Practice Address - City:COZAD
Practice Address - State:NE
Practice Address - Zip Code:69130-1708
Practice Address - Country:US
Practice Address - Phone:308-784-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion