Individual
TERESA D GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP GNP
Contact information
Practice address
91 ENTERPRISE DR, ROCKY MOUNT, NC 27804
(252) 451-3200
(252) 937-3107
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 451-3200
(252) 937-6278
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
600092
NC
363LG0600X
Gerontology Nurse Practitioner
600092
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1850C
BCBS OF NC
NC
01
—
500005758
RAILROAD MEDICARE
NC
05
—
7000423
—
NC
Enumeration date
09/07/2005
Last updated
03/08/2019
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