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NPI Code Detail

MEDICARE: LORI ANN GIBSON

MEDICARE:   LORI ANN GIBSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376J00000XHomemaker1831830OH

General Provider Information

NPI Number : 1720768435
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ANN GIBSON
Provider Business Mailing Address
First Line : 13028 HAMPTON CLUB DR APT 103
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-7456
Country : US
Telephone Number : 216-471-0833
Fax Number :
Provider Business Practice Location Address
First Line : 7815 NORMANDIE BLVD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-8827
Country : US
Telephone Number : 216-471-0833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2023
Last Update Date : 07/19/2023

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Directions to “ LORI ANN GIBSON ” Practice Location

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