Individual provider · Type 1 NPI

Radine A. Gibson

Pediatric Nurse Practitioner · Morgantown, WV

NPI number 1083794150 Active

Practice location

1 Stadium Drive
Morgantown, WV 26506

Call (304) 598-4800 Map

Fax (304) 293-6963

Mailing address

PO Box 897
Morgantown, WV 26507-0897

Specialties and licenses

Taxonomy	Code	License
Pediatric Nurse Practitioner Primary	363LP0200X	048891 (WV)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1083794150

Radine A. Gibson's National Provider Identifier is 1083794150, issued on Oct 16, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Morgantown, WV. The record was last updated on Jul 8, 2007.