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Individual

JORDAN NICOLE GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2111
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2025-0008
NM
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/13/2024
Last updated
06/04/2025
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