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Individual

JENNIFER MAUREEN GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1408 CAMPBELL DR STE 200, IRONTON, OH 45638-2301
(740) 534-9202
(740) 532-4777
Mailing address
305 N 5TH ST, IRONTON, OH 45638-1578
(740) 532-4858
(740) 532-4859

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
68316
WV
363LF0000X
Family Nurse Practitioner
Primary
NP13208
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0057626
OH
05
3810021896
WV
05
7100184340
KY
Enumeration date
11/04/2011
Last updated
01/29/2018
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