Individual
ELAYNA BROOKE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
411 E CHESTNUT ST # 5A, LOUISVILLE, KY 40202-1713
(502) 588-7450
(502) 588-7728
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 559-9337
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10004124A
IN
363A00000X
Physician Assistant
Primary
TC154
KY
Other
Enumeration date
07/14/2023
Last updated
08/01/2024
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