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General NPI Number Information
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NPI Number | 1598346876
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Entity Type | Organization
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Legal Business Name | GIBBS COMPREHENSIVE CARE, LLC
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Dates
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Enumeration Date | 04/18/2021
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 780 4TH AVE
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City | YORK
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State | AL
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Zip | 36925-2104
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Country | US
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Telephone | 601-531-3200
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Fax | 601-531-3107
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | TOOMSUBA
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State | MS
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Zip | 39364-0188
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Country | US
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Telephone | 601-531-3200
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Fax | 601-531-3107
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRACI LYNN GIBBS
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Credential | PHD, PMHNP-BC
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Telephone | 601-531-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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