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Individual

MS. TELIAH RAE GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN, CBS

Contact information

Practice address
500 PLAZA CT STE A, EAST STROUDSBURG, PA 18301-8262
(570) 476-3585
(570) 421-9014
Mailing address
5106 PINE RIDGE RD N, EAST STROUDSBURG, PA 18302-8673
(570) 369-2849

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310699
PA
174400000X
Specialist
PA
174N00000X
Lactation Consultant (Non-RN)
PA

Other

Enumeration date
07/02/2025
Last updated
07/02/2025
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