IndividualActive
Cody Gibbs, NP-C
NPI 1205335510 · Nurse Practitioner · Canton, IL
Provider details
- NPI number
- 1205335510
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP-C
- Sex
- Male
- Sole proprietor
- No
- License
- 209017218 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
180 S Main St
Canton, IL 61520-2608
Phone: (309) 647-0201
Fax: (309) 649-6880
Approximate (ZIP-level) locationGet directions
Mailing address
180 S Main St
Canton, IL 61520-2608
Additional practice locations (1)
- 601 E Fort StFarmington, IL 61531-1338Phone: (309) 245-2406Fax: (309) 649-6880
Registry dates
- Enumerated
- 2018-02-02
- Last updated
- 2021-04-13
- Certified
- 2021-04-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.