# MS. TELIAH RAE GIBSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063301133
- **Gender:** F
- **Credential:** LPN, CBS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | 310699 | PA | Yes |
| 174400000X | Specialist | — | PA | — |
| 174N00000X | Lactation Consultant (Non-RN) | — | PA | — |

## Other

- **Enumeration date:** 07/02/2025
- **Last updated:** 07/02/2025