Individual
MRS. MISTY MICHELLE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3340 PLAYERS CLUB PKWY, SUITE 350, MEMPHIS, TN 38125-8933
(901) 844-1590
(901) 844-1592
Mailing address
206 DIXON CT, EVANS, GA 30809-4302
(229) 378-0295
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN150024
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431180317B
—
GA
05
—
GAN827
—
SC
Enumeration date
06/04/2007
Last updated
09/29/2016
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