Individual
MRS. SHARICKA LEE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBA, BSRT (R)
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
438191
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
438191
AMERICAN SOCIETY OF RADIOLOGIC TECHNOLOGY
TN
Enumeration date
09/13/2017
Last updated
09/13/2017
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