| Doctor Name: | HARRIET J GIBBONS |
| NPI Number: | 1760400311 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PAC0199 |
| Business Practice Address: | 621 Demers Ave East Grand Forks, MN - 567211833 |
| Business Phone Number: | 2187735800 |
| Business Fax Number: | 2187735888 |
| Mailing Address: | 621 Demers Ave, EAST GRAND FORKS |
| State: | MN |
| Postal Code: | 567211833 |
| Phone Number: | 2187735800 |
| Fax Number: | 2187735888 |
| NPI Enumeration Date: | 07/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PAC0199 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |