Individual
CARLIE JORDAN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
915 W HAZELHURST ST, FERNDALE, MI 48220-1679
(586) 382-2629
Mailing address
915 W HAZELHURST ST, FERNDALE, MI 48220-1679
(586) 382-2629
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
Primary
4704374179
MI
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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