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General NPI Number Information
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NPI Number | 1487494175
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Entity Type | Individual
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Provider Name | EMILY GIBSON PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 2010 DOCTOR OATES DR
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City | MARTINSBURG
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State | WV
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Zip | 25401-8896
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Country | US
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Telephone | 304-596-5780
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Fax |
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Provider Business Mailing Address
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Address Line | 37 ROSCO DRIVE
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City | BUNKER HILL
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State | WV
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Zip | 25413
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | ACOO7144
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024190704
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 120187
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License Number State | WV
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