Individual
KEISHA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 MANNING DR, RM 1107G W WING, CHAPEL HILL, NC 27514-4220
(919) 966-1072
Mailing address
101 MANNING DR, RM 1107G W WING, CHAPEL HILL, NC 27514-4220
(919) 966-1072
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
2008-00780
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2007
Last updated
05/10/2021
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