Provider Demographics
NPI:1801024294
Name:GIBSON, BEVERLY ANN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:BEVERLY
Middle Name:ANN
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S 2ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5729
Mailing Address - Country:US
Mailing Address - Phone:701-757-5463
Mailing Address - Fax:877-651-1381
Practice Address - Street 1:108 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MCVILLE
Practice Address - State:ND
Practice Address - Zip Code:58254-4203
Practice Address - Country:US
Practice Address - Phone:701-322-4347
Practice Address - Fax:701-322-2244
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3081363LF0000X
NDR28481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily