Individual
NICHALA KADENE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
681 WESTMINSTER RD, NORTH BALDWIN, NY 11510-1038
(516) 884-5092
Mailing address
681 WESTMINSTER RD, NORTH BALDWIN, NY 11510-1038
(516) 884-5092
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
730167
NY
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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