Individual
CAROL MARIE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NONE
Contact information
Practice address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 252-5621
(208) 252-5621
Mailing address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 252-5621
(208) 648-4167
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
—
—
Other
Enumeration date
01/28/2026
Last updated
01/28/2026
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