Provider Demographics
NPI:1154413243
Name:GIBSON, JEWYL C (DNP, MSN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:JEWYL
Middle Name:C
Last Name:GIBSON
Suffix:
Gender:F
Credentials:DNP, MSN, PMHNP-BC
Other - Prefix:MRS
Other - First Name:JEWYL
Other - Middle Name:C
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:2212 OLD MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-4374
Mailing Address - Country:US
Mailing Address - Phone:615-497-0441
Mailing Address - Fax:
Practice Address - Street 1:633 THOMPSON LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3616
Practice Address - Country:US
Practice Address - Phone:615-499-7406
Practice Address - Fax:833-968-2944
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7971363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily