Gibson, Alycia D

Gibson, Alycia D is an individual health care provider with primary practice located at 239 Tyson Ave , Paris TN 38242-4544. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Gibson, Alycia D can be contacted via phone (731) 644-8208.

Contact Information

Primary practice address
239 Tyson Ave Paris TN 38242-4544
Phone: (731) 644-8208
Fax: (731) 644-8551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0000001274 Tennessee

Profile Details

NPI number 1073544516
LBN Legal business name Gibson, Alycia D
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Aug 25th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073544516 NPPES
Tennessee Other 44D2000904 CLIA
Tennessee MEDICAID 1515861 CLIA

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