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Individual

DWALA GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
(580) 286-1087
Mailing address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
(580) 286-1087

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0083725
OK

Other

Enumeration date
05/14/2015
Last updated
09/07/2016
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