| Doctor Name: | MRS. KELLEY I GIBBS |
| NPI Number: | 1124211073 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 71000761 |
| Business Practice Address: | 1650 W Oak St Zionsville, IN - 460771962 |
| Business Phone Number: | 3177336300 |
| Business Fax Number: | |
| Mailing Address: | 1650 W Oak St, ZIONSVILLE |
| State: | IN |
| Postal Code: | 460771962 |
| Phone Number: | 3177336300 |
| Fax Number: | |
| NPI Enumeration Date: | 08/23/2007 |
| NPI Last Update Date: | 07/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 71000761 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |