Individual
MISS LESIA DENISE GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
375A LOVE CV, BRANDON, MS 39042-8320
(601) 966-4564
Mailing address
375A LOVE CV, BRANDON, MS 39042-8320
(601) 966-4564
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P235121
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164W00000X
IN HOME SENIOR CARE
MS
01
—
841950454
164W00000X
MS
01
—
841950454
IN HOME SENIOR CARE
—
Enumeration date
06/03/2019
Last updated
06/03/2019
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