Individual
GRACE A GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
Mailing address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
5101015015
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700532
PHP
MI
01
—
1020336
MHP HAN
MI
01
—
160C311260
BCBSM CHOICE BCN COM BLUE
MI
05
—
4865240
—
MI
05
—
7100349070
—
KY
Enumeration date
07/19/2006
Last updated
10/15/2024
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