Individual
LATOYA D GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-2455
(864) 455-2450
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
24285
SC
363LG0600X
Gerontology Nurse Practitioner
24285
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP7302
—
SC
Enumeration date
10/12/2020
Last updated
12/03/2025
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