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1003510181
QUARTIVIA GIBSON
LAFAYETTE, LA
NPI
1003510181
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MS 905847)
Enumeration Date
2023-03-30
Last Update Date
2023-06-09
Business Address
QUARTIVIA GIBSON
202 GENERAL GARDNER AVE
LAFAYETTE, LA 70501-7824
Phone number: 337-232-9457
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Mailing Address
QUARTIVIA GIBSON
5439 BURKHARDT RD
DAYTON, OH 45431-2111
Phone number: 601-910-1168
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