Provider Demographics
NPI:1053729913
Name:GIBSON, JENNIFER JENNINGS (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JENNINGS
Last Name:GIBSON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 S PHILIPPE AVE
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-3749
Mailing Address - Country:US
Mailing Address - Phone:225-644-1990
Mailing Address - Fax:
Practice Address - Street 1:2524 S PHILIPPE AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3749
Practice Address - Country:US
Practice Address - Phone:225-644-1990
Practice Address - Fax:888-837-2317
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily