Individual
ANITA JO GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2755 QUAIL LN, LONGVIEW, TX 75602-7469
(903) 746-0494
Mailing address
2755 QUAIL LN, LONGVIEW, TX 75602-7469
(903) 746-0494
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
822864
TX
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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