Michael L. Gibson, F.N.P.
Individual provider Active NPI Nurse Practitioner · Hayfork, CA
NPI 1376774034 · NPPES record last updated Jul 29, 2009
Key facts
- NPI
- 1376774034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 18917 (CA)
- Practice address
- 6961 Highway 3
Hayfork, CA 96041-6961 - Phone
- (530) 628-5517
- Fax
- (530) 628-5524
- NPI assigned
- Jul 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18917 | CA | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 18917 | CA | Yes |
Addresses
Primary practice location
6961 Highway 3
Hayfork, CA 96041-6961
Mailing address
PO Box 220
Hayfork, CA 96041-0220
Phone (530) 628-5517
Other providers in Hayfork, CA
- Macy Marie Belongia
- Donald E. Krouse, M.D. Inc
- Allis Raelyn Fielding
- Gerald Reichelderfer
- Daniel Lee Humphrey
- Mountain Communities Healthcare District
- Mountain Meadow Speech Therapy
- Deidre Leann Pickett
- Holly Nicole Przybylowski
All providers in Hayfork, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.