Individual
SHANISE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1565 EBENEZER RD STE 111, ROCK HILL, SC 29732-2494
(803) 376-3474
Mailing address
436 DUTCH WHITE DR, CLOVER, SC 29710-6926
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
273853
SC
Other
Enumeration date
05/09/2026
Last updated
05/09/2026
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