Provider Demographics
NPI:1760645014
Name:GIPSON, TOMEKA DANELLY (RN)
Entity Type:Individual
Prefix:
First Name:TOMEKA
Middle Name:DANELLY
Last Name:GIPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 MILDRED ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-3929
Mailing Address - Country:US
Mailing Address - Phone:334-834-8281
Mailing Address - Fax:
Practice Address - Street 1:2105 EAST SOUTH BLV
Practice Address - Street 2:BAPTIST MEDICAL CENTER SOUTH
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116
Practice Address - Country:US
Practice Address - Phone:334-288-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1114433163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine