Individual
MS. TRACIE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9105 FRANKLIN SQUARE DR FL 3, BALTIMORE, MD 21237-3930
(410) 887-6452
Mailing address
9105 FRANKLIN SQUARE DR FL 3, BALTIMORE, MD 21237-3930
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
R166589
MD
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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