Individual
CARLA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10795 ORAL ZUMWALT WAY, MISSOULA, MT 59803-9791
(406) 543-5444
(406) 543-5447
Mailing address
2120 S RESERVE ST # 401, MISSOULA, MT 59801-6451
(406) 543-5444
(406) 543-5447
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
016250
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
373780
BLUE CROSS BLUE SHIELD
MT
05
—
4302402
—
MT
Enumeration date
10/16/2006
Last updated
09/27/2023
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