Provider Demographics
NPI:1821980269
Name:GIBSON, SHAWANA KACHER
Entity type:Individual
Prefix:
First Name:SHAWANA
Middle Name:KACHER
Last Name:GIBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10795 BURLINGTON ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-9470
Mailing Address - Country:US
Mailing Address - Phone:251-421-8605
Mailing Address - Fax:
Practice Address - Street 1:10795 BURLINGTON ESTATES DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-9470
Practice Address - Country:US
Practice Address - Phone:251-421-8605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95144552163W00000X
CT209638163W00000X
AL1-146316163W00000X
NV869985163W00000X
MN2524713163W00000X
AK208938163W00000X
NY926799163W00000X
DCRN500017312163W00000X
HI118325163W00000X
MI4704413458163W00000X
OR10009292163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse