Individual
DR. KIMBERLY GIBSON LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
135 NICKLAUS CIR, SOCIAL CIRCLE, GA 30025-5346
(770) 714-5860
Mailing address
135 NICKLAUS CIR, SOCIAL CIRCLE, GA 30025-5346
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002189
GA
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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