Dwala M Gibson (NPI# 1346628088, PAC ID# 3274822630) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1346628088 |
| PAC ID by PECOS | 3274822630 |
| Professional Enrollment ID | I20160525001521 |
| Full Name | Dwala M Gibson |
| Address |
75 Norwich Westerly Rd Ledyard CT 06339-1128 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070024 | WILLIAM W BACKUS HOSPITAL |
| 070007 | LAWRENCE & MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 75 Norwich Westerly Rd, Ledyard, CT 06339-1128 |
| Street Address |
75 NORWICH WESTERLY RD |
| City | LEDYARD |
| State | CT |
| Zip | 06339-1128 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marilyn A Richard | Certified Clinical Nurse Specialist (cns) | 333 Colonel Ledyard Hwy, Ledyard, CT 06339-1909 |
| City | LEDYARD |
| Zip Code | 06339 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LEDYARD + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Dwala M Gibson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.