Individual
MICHELLE JENISE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC, NNP-BC
Contact information
Practice address
4900 MUELLER BLVD, AUSTIN, TX 78723-3079
(512) 324-0173
Mailing address
20502 TRACTOR DR UNIT A, PFLUGERVILLE, TX 78660-7127
(512) 736-2430
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
AP143745
TX
363LP0222X
Critical Care Pediatric Nurse Practitioner
AP143745
TX
Other
Enumeration date
10/24/2019
Last updated
12/29/2022
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