Healthcare Provider Details

I. General information

NPI: 1861313025
Provider Name (Legal Business Name): BRIANA MICHELLE GIBBS WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARKVIEW PL
SAINT LOUIS MO
63110-1038
US

IV. Provider business mailing address

1 PARKVIEW PL
SAINT LOUIS MO
63110-1038
US

V. Phone/Fax

Practice location:
  • Phone: 314-859-0692
  • Fax:
Mailing address:
  • Phone: 314-859-0692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number2019038064
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: