Individual
KACIE LYNN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1020 THOMPSON ST, JERSEY SHORE, PA 17740-1729
(570) 398-1991
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP028013
PA
363LA2200X
Adult Health Nurse Practitioner
SP028013
PA
Other
Enumeration date
08/23/2023
Last updated
12/02/2023
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