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General NPI Number Information
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NPI Number | 1184544017
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Entity Type | Organization
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Legal Business Name | LIVE OAK PSYCHIATRIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 610 COUNTY RD 415
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City | ENGLEWOOD
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State | TN
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Zip | 37329
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Country | US
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Telephone | 251-284-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 1306 DECATUR PIKE # 1008
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City | ATHENS
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State | TN
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Zip | 37303-2418
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Country | US
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Telephone | 251-284-2010
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HARLEY GIBBS
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Credential | PMHNP
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Telephone | 251-284-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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