Individual
DR. LYDIA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
609 W GERMANTOWN PIKE STE 260, NORRISTOWN, PA 19403-4243
(484) 622-7820
(484) 622-7830
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-1825
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP025660
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1040204430004
—
PA
Enumeration date
04/27/2022
Last updated
08/24/2022
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