Individual
JANINE GIBBS LARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
139 WATKINS RD, VICKSBURG, MS 39180-7291
(601) 738-5308
Mailing address
139 WATKINS RD, VICKSBURG, MS 39180-7291
(601) 738-5308
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901736
MS
Other
Enumeration date
09/30/2016
Last updated
09/30/2016
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