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1609554146
JENNA RAE GIBSON
MANDEVILLE, LA
NPI
1609554146
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: LA 230156)
Enumeration Date
2023-07-06
Last Update Date
2023-08-09
Business Address
JENNA RAE GIBSON FNP
807 SHADOW OAK LN
MANDEVILLE, LA 70471-1249
Phone number: 504-800-8313
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Mailing Address
JENNA RAE GIBSON FNP
807 SHADOW OAK LN
MANDEVILLE, LA 70471-1249
Phone number: 504-800-8313
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