| NPI | 1619168473 |
|---|---|
| Former Name | SHANNON M GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: SC 3302) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: OH 08967) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2023-03-07 |