Individual
JAIME L GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1032 E SUMNER ST, HARTFORD, WI 53027-1608
(262) 673-2300
(262) 670-7620
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10883
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100197671
—
WI
Enumeration date
02/24/2022
Last updated
03/31/2025
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