Individual
CORENA R GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
69 S MAIN ST, WHITLEY CITY, KY 42653-6043
(606) 376-7399
(606) 376-7396
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 864-1472
(270) 864-1472
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3003843
KY
363LF0000X
Family Nurse Practitioner
APN6725
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78009065
—
KY
Enumeration date
11/23/2005
Last updated
09/15/2014
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