Provider Demographics
NPI:1730231929
Name:GIBSON, GAIL G (FNP)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:G
Last Name:GIBSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:G
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1417 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3634
Mailing Address - Country:US
Mailing Address - Phone:901-272-7200
Mailing Address - Fax:901-260-5916
Practice Address - Street 1:1417 MONROE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3634
Practice Address - Country:US
Practice Address - Phone:901-272-7200
Practice Address - Fax:901-260-5916
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000010670363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily