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Individual
MARIAH DEE GIPSON-LEROUX
Active
Individual
MARIAH DEE GIPSON-LEROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-15427
NCMB
NC
01
—
027407
NYSED PHYSICIAN ASSISTANT LICENSE
NY
Enumeration date
07/21/2021
Last updated
09/15/2025
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