Individual
STEPHANIE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12016 N RADIO STATION RD, SENECA, SC 29678-1143
(864) 882-6141
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8614
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24222
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP7262
—
SC
Enumeration date
10/23/2020
Last updated
09/26/2023
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