Individual
SIATA ANICA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4467 OLD BRANCH AVE STE 207, TEMPLE HILLS, MD 20748-1854
(301) 630-3900
Mailing address
9002 EARLY APRIL WAY, COLUMBIA, MD 21046-1473
(240) 277-7554
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R175106
MD
Other
Enumeration date
08/18/2018
Last updated
06/10/2023
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