Free National NPI Number Registry
Carol Ann Jackson-Gibson
Home > Carol Ann Jackson-Gibson
NPI Number Detailed Information
Provider Information:
| Name: | Carol Ann Jackson-Gibson |
| Gender: | F |
| Provider License Number If Given: | 176786 |
NPI Information:
| NPI: | 1164421442 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/19/2005 |
| Last Update Date: | 3/11/2013 |
Provider Business Mailing Address:
| Address: | 1150 YOUNGS RD SUITE 111 Williamsville, NY 14221 |
| Phone Number: | 7166887622 |
| Fax Number: | 7166887592 |
Provider Business Practice Location Address:
| Address: | 1150 YOUNGS RD SUITE 111 Williamsville, NY 14221 |
| Phone Number: | 7166887622 |
| Fax Number: | 7166887592 |
Provider Taxonomy:
| Primary: | 2085N0904X |
| Secondary (if any): | 2085R0202X |
| State: | NY |
