Individual
JACQUINNETTA LATRISH GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
(859) 253-1686
Mailing address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
(859) 253-1686
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/21/2017
Last updated
07/02/2020
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