Individual
MR. BRAD GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
10552 SUCCESS LN STE L, CENTERVILLE, OH 45458-3664
(937) 280-5711
Mailing address
10552 SUCCESS LN STE L, CENTERVILLE, OH 45458-3664
(937) 280-5711
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0029637
OH
Other
Enumeration date
08/28/2020
Last updated
01/24/2024
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