Individual
DANIELLE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1602 HATCHER LANE, COLUMBIA, TN 38401
(931) 490-1000
(931) 388-1548
Mailing address
1602 HATCHER LANE, COLUMBIA, TN 38401
(931) 388-0777
(931) 388-1548
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD36402
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200149150
—
IN
05
—
3403473
—
TN
01
—
4054110
BLUE CARE/TN CARE
—
Enumeration date
06/20/2006
Last updated
05/20/2011
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