Provider Demographics
NPI:1770797722
Name:GIPSON, CLARICE S (RN)
Entity type:Individual
Prefix:MRS
First Name:CLARICE
Middle Name:S
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 1:599 MYERS RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-4584
Mailing Address - Country:US
Mailing Address - Phone:931-967-2722
Mailing Address - Fax:
Practice Address - Street 1:338 JOYCE LN
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-3326
Practice Address - Country:US
Practice Address - Phone:931-967-3826
Practice Address - Fax:931-962-1168
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000027752163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health