Provider Demographics
NPI:1841234309
Name:GIBBS, JAMIE SUE (ANP-BC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:SUE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N KING ST STE 500
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-5053
Mailing Address - Country:US
Mailing Address - Phone:828-694-7991
Mailing Address - Fax:828-694-7992
Practice Address - Street 1:100 N KING ST STE 500
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5053
Practice Address - Country:US
Practice Address - Phone:828-694-7991
Practice Address - Fax:828-694-7992
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC133478363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health