Individual
JONATHAN GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
282 SHEPPARD ST, SUITE B, MINDEN, LA 71055-4205
(318) 377-5436
(318) 382-1190
Mailing address
282 SHEPPARD ST, SUITE B, MINDEN, LA 71055-4205
(318) 377-5436
(318) 382-1190
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
HC0011912
LA
251E00000X
Home Health Agency
Primary
—
LA
261QA0600X
Adult Day Care Clinic/Center
—
—
Other
Enumeration date
02/07/2017
Last updated
04/20/2023
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