Individual
KATIE BETH GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 PARKWAY LN STE 100, PETAL, MS 39465-3059
(601) 705-2897
Mailing address
46 CARRIAGE PARKE DR, PURVIS, MS 39475-6052
(662) 825-4731
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
908429
MS
363LF0000X
Family Nurse Practitioner
Primary
905640
MS
363LF0000X
Family Nurse Practitioner
908429
MS
Other
Enumeration date
05/01/2026
Last updated
07/17/2026
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