Individual
LACY GIBBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
949 E TAFT AVE, SAPULPA, OK 74066-5728
(918) 224-6079
(918) 224-6126
Mailing address
701 CEDAR LAKE BLVD STE 120, OKLAHOMA CITY, OK 73114-7806
(405) 445-1210
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
117838
OK
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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