Individual
MS. SAMANTHA SMITH GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
101 DEVEREAUX DR, MADISON, MS 39110-9353
(601) 946-9650
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
903674
MS
363LP2300X
Primary Care Nurse Practitioner
Primary
903674
MS
Other
Enumeration date
01/13/2020
Last updated
05/07/2026
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