Provider Demographics
NPI:1609606441
Name:GIBBS, JANEA (DNP, MBA, AGPCNP-BC)
Entity type:Individual
Prefix:DR
First Name:JANEA
Middle Name:
Last Name:GIBBS
Suffix:
Gender:F
Credentials:DNP, MBA, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5253
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-0253
Mailing Address - Country:US
Mailing Address - Phone:856-288-6109
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 5253
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-0253
Practice Address - Country:US
Practice Address - Phone:856-288-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2024059178363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology