MEDICARE: TASHA GIBBS

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
1	225700000X	Massage Therapist	10004	NV

General Provider Information

NPI Number	:	1881264422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TASHA GIBBS

Provider Business Mailing Address
First Line	:	3161 SUNRIDGE HEIGHTS PKWY UNIT 4109
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-5098
Country	:	US
Telephone Number	:	928-303-8480
Fax Number	:

Provider Business Practice Location Address
First Line	:	3161 SUNRIDGE HEIGHTS PKWY UNIT 4109
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-5098
Country	:	US
Telephone Number	:	928-303-8480
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2021
Last Update Date	:	06/27/2021

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Directions to “ TASHA GIBBS ” Practice Location

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