Provider Demographics
NPI:1831220003
Name:GIBBS, SHERYL ZEE (LPN)
Entity type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:ZEE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7435 STATE ROUTE 134
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45142-9126
Mailing Address - Country:US
Mailing Address - Phone:513-465-0826
Mailing Address - Fax:
Practice Address - Street 1:7435 STATE ROUTE 134
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:OH
Practice Address - Zip Code:45142-9126
Practice Address - Country:US
Practice Address - Phone:937-364-1946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN077845164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND2546534Medicaid