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NPI Code Detail

MEDICARE: AMELIA JOHNSON GIBBS CSFA

MEDICARE: AMELIA JOHNSON GIBBS CSFA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246ZC0007XSurgical Assistant

General Provider Information

NPI Number : 1881252484
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA JOHNSON GIBBS CSFA
Provider Business Mailing Address
First Line : 8425 CUMBERLAND PL
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6544
Country : US
Telephone Number : 225-924-7514
Fax Number : 225-922-8917
Provider Business Practice Location Address
First Line : 8425 CUMBERLAND PL
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6544
Country : US
Telephone Number : 225-924-7514
Fax Number : 225-922-8917
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2019
Last Update Date : 05/30/2019

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Directions to “ AMELIA JOHNSON GIBBS CSFA” Practice Location

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