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1396412961
DEIDRE GIBSON
WINSTON SALEM, NC
NPI
1396412961
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NC 5013002)
Enumeration Date
2021-08-23
Last Update Date
2021-08-23
Business Address
DEIDRE GIBSON
1094 HANES MALL BLVD STE 1140
WINSTON SALEM, NC 27103-1309
Phone number: 743-212-7678
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Mailing Address
DEIDRE GIBSON
1094 HANES MALL BLVD STE 1140
WINSTON SALEM, NC 27103-1309
Phone number:
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