Individual
MR. KYLE STEVEN GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
743 SPRING ST NE, TRAUMA & ACUTE CARE SURGERY, GAINESVILLE, GA 30501-3715
(770) 219-3202
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN226432
GA
363LC0200X
Critical Care Medicine Nurse Practitioner
RN226432
GA
363LG0600X
Gerontology Nurse Practitioner
RN226432
GA
Other
Enumeration date
04/12/2017
Last updated
05/05/2017
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