GIBBS WOUND CARE LLC NPI 1902279110

NPI Information

NPI: 1902279110
Provider Name: GIBBS WOUND CARE LLC
Classification: Nurse Practitioner - 363LC0200X
Specialization: Critical Care Medicine
Entity Type: Organization
Address: 2210 BARRON RD
ROOM 205
POPLAR BLUFF, MO
ZIP 63901
Phone: (573) 686-4133

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NPI Details

GIBBS WOUND CARE LLC is a critical care medicine nurse practitioner in Poplar Bluff, MO. GIBBS WOUND CARE LLC NPI is 1902279110. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2210 BARRON RD
ROOM 205
POPLAR BLUFF, MO
ZIP 63901-908
Phone: (573) 686-4133
Fax: (573) 778-1099

The provider's authorized official is Devona D Gibbs .
The authorized official title is Nurse Practitioner and has the following contact phone number (573) 686-4133.

The enumeration date for this NPI number is 11/10/2015 and was last updated on 11/10/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LC0200X	Nurse Practitioner	Critical Care Medicine	0236239	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S06965	MEDICARE UPIN	MISSOURI
2	064033	OTHER	MISSOURI	MISSOURI STATE BOARD OF NURSING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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