Individual
BRIAN GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1730 DORCHESTER DR, SOUTHAVEN, MS 38671-5723
(731) 394-1145
Mailing address
1393 HIGHWAY 51 S, HERNANDO, MS 38632-1149
(901) 626-9846
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
27083
TN
363L00000X
Nurse Practitioner
Primary
903739
MS
Other
Enumeration date
02/07/2020
Last updated
02/06/2022
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