Individual
TYLER GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
2923 W BOWMAN ST, MUNCIE, IN 47304-2542
(765) 729-6532
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95338777
CA
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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