Individual
AMANDA STARR GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6000
Mailing address
7687 E 330 RD, TALALA, OK 74080-9622
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0101926
OK
Other
Enumeration date
09/25/2015
Last updated
09/25/2015
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