Individual
MRS. ALEXIS MARIE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 E MARKET ST STE A, LOUISVILLE, KY 40202-1218
(502) 588-4340
Mailing address
1838 PAYNE ST, LOUISVILLE, KY 40206-1943
(502) 759-4571
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
1159296
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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