Provider Demographics
NPI:1821317504
Name:GIBSON, WHITNEY KAYE (MA)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:KAYE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 NW 167TH CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-8978
Mailing Address - Country:US
Mailing Address - Phone:405-626-5150
Mailing Address - Fax:
Practice Address - Street 1:1245 WHIPPOORWILL VIS
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-7029
Practice Address - Country:US
Practice Address - Phone:405-769-1034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program