Individual
TAMIKA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(317) 353-2628
Mailing address
6232 NIMITZ DR, INDIANAPOLIS, IN 46219-2128
(317) 353-2628
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
48010504492
IN
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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