Provider Demographics
NPI:1962703132
Name:GEBBEN, JODY ANNETTE (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:JODY
Middle Name:ANNETTE
Last Name:GEBBEN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MRS
Other - First Name:JODY
Other - Middle Name:ANNETTE
Other - Last Name:SLUSHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1573 W AJO WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-5738
Mailing Address - Country:US
Mailing Address - Phone:520-908-4047
Mailing Address - Fax:520-908-4001
Practice Address - Street 1:1573 W AJO WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-5738
Practice Address - Country:US
Practice Address - Phone:520-908-4047
Practice Address - Fax:520-908-4001
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN109629163WE0003X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WE0003XNursing Service ProvidersRegistered NurseEmergency