Individual
CARLIE JORDAN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
(313) 876-1305
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(800) 999-5829
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
Primary
4704374179
MI
176B00000X
Midwife
4704374179
MI
367A00000X
Advanced Practice Midwife
Primary
4704374179
MI
Other
Enumeration date
08/07/2024
Last updated
07/14/2026
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