Individual
BEVERLY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
Mailing address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
127600
MS
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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