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Individual
MICHAEL GIBSON
Active
Individual
MICHAEL GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN272110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN272110
PA LPN LICENCE
PA
Enumeration date
08/09/2017
Last updated
08/09/2017
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