# JONATHAN GIBSON

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

## Provider details

- **NPI number:** 1417495771
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 172V00000X | Community Health Worker | HC0011912 | LA | — |
| 251E00000X | Home Health Agency | — | LA | Yes |
| 261QA0600X | Adult Day Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 02/07/2017
- **Last updated:** 04/20/2023