Individual
KIM GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
16405 SUNNY GLENN AVE, CLEVELAND, OH 44128-3776
(216) 801-9792
Mailing address
16405 SUNNY GLENN AVE, CLEVELAND, OH 44128-3776
(216) 612-1008
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN378521
OH
363LF0000X
Family Nurse Practitioner
CNP.0031125
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2206615
—
OH
Enumeration date
03/27/2007
Last updated
04/06/2022
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