Individual
NICHOLAS R GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, NREMT-P
Contact information
Practice address
11700 N MERIDIAN ST, CARMEL, IN 46032-4656
(317) 880-3900
(317) 880-0545
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003409A
IN
363A00000X
Physician Assistant
7466
GA
Other
Enumeration date
01/29/2015
Last updated
06/27/2022
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