Individual
AVERY NICOLE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(405) 271-2424
Mailing address
10922 S 86TH EAST AVE, TULSA, OK 74133-7226
(918) 932-9867
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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