Melissa D. Gibbs, LPN
Individual provider Active NPI Licensed Practical Nurse · Fairfield, IL
NPI 1790043263 · NPPES record last updated May 2, 2012
Key facts
- NPI
- 1790043263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 043075009 (IL)
- Practice address
- 209 NW 11TH St
Fairfield, IL 62837-1218 - Phone
- (618) 842-4470
- NPI assigned
- May 2, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043075009 | IL | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043075009 | IL | Yes |
Addresses
Primary practice location
209 NW 11TH St
Fairfield, IL 62837-1218
Mailing address
PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2436
Other providers in Fairfield, IL
- Melissa Felowitz
- Leyth Fenton
- Ryan Douglas Ferguson
- Emma Funk
- Nicole Fyie
- Dana Lynn Gilbert
- Lauren Griswold
- Francis Guerra-Bauman
- Bryce Michael Harrison
- Michaela Blaire Harrison
All providers in Fairfield, IL · Licensed Practical Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.