Individual
LAKISHA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
590 HIGHWAY 18 W, QUITMAN, MS 39355-8739
(601) 934-9629
(601) 429-1314
Mailing address
590 HIGHWAY 18 W, QUITMAN, MS 39355-8739
(601) 934-9629
(601) 429-1314
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
25D2248675
MS
363LF0000X
Family Nurse Practitioner
Primary
907056
MS
Other
Enumeration date
01/15/2022
Last updated
11/19/2024
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