# EMILY MARION GIBSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1093181463
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | MA057964 | PA | — |
| 363AS0400X | Surgical Physician Assistant | — | PA | Yes |

## Other

- **Enumeration date:** 08/19/2015
- **Last updated:** 11/17/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1031098860001 | — | PA |