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Individual
MRS. OLIVIA RUTH GIBSON
Active
Individual
MRS. OLIVIA RUTH GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN/APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN113495
GA
363L00000X
Nurse Practitioner
Primary
RN113495
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000759536I
—
GA
Enumeration date
07/07/2006
Last updated
11/15/2023
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