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NPI Profile for CORA L GIBBS in EDINA, MN.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1124574322 |
|
| Status | Active | |
| Credentials | PA (Physician Assistant) | |
| Entity | Individual | |
| Enumeration date | 08/28/2016 | |
| Last updated | 08/28/2016 - About 10 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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CORA L GIBBS
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CORA L GIBBS, PA