Individual
MRS. OLLIE RENEE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
57 SUMMIT DR, CORBIN, KY 40701-2746
(606) 528-9700
(606) 528-8423
Mailing address
57 SUMMIT DR, CORBIN, KY 40701-2746
(606) 528-9700
(606) 528-8423
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3016521
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3016521
FAMILY MEDICINE
KY
05
—
F06212829
—
KY
Enumeration date
11/01/2021
Last updated
11/01/2021
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