Healthcare Provider Details

I. General information

NPI: 1982520151
Provider Name (Legal Business Name): BRIANA J GIBSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MATTHEWS TOWNSHIP PKWY
MATTHEWS NC
28105-5402
US

IV. Provider business mailing address

9954 TREESIDE LN
MATTHEWS NC
28105-7221
US

V. Phone/Fax

Practice location:
  • Phone: 704-264-3475
  • Fax: 704-264-1395
Mailing address:
  • Phone: 704-264-3475
  • Fax: 704-264-1395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number332320
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: