Individual
MRS. JENNIFER MULLA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7500
Mailing address
1332 LLEWELLYN AVE, NORFOLK, VA 23517-2248
(203) 257-7854
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
63714
TN
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
63714
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2014
Last updated
08/12/2021
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