Organization
N GIBSON PSYCH NP
Active
Other names
N GIBSON PSYCH NP
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY L. GIBSON APRN (OWNER/NP)
(850) 818-2698
Entity
Organization
Contact information
Practice address
312 THOMAS DR, PANAMA CITY, FL 32408-4902
(850) 818-2698
Mailing address
1016 THOMAS DR # 332, PANAMA CITY, FL 32408-7444
(850) 818-2698
(949) 437-3422
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12023480
CAQH
FL
05
—
768938100
—
FL
01
—
OV598
GROUP MEDICARE NUMBER
FL
01
—
OV604
INDIVIDUAL PTAN NUMBER
FL
Enumeration date
10/30/2021
Last updated
04/27/2022
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