Individual provider · Type 1 NPI

Jacqueline Gaillard Gibson, PA-C

Medical Physician Assistant · Raleigh, NC

NPI number 1093721714 Active

Practice location

820 S Boylan Ave
Raleigh, NC 27603-2246

Call (919) 733-0740 Map

Mailing address

216 Wild Holly Ln
Holly Springs, NC 27540-8654

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X103859 (NC)

Medical Physician Assistant: Definition to come...

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About NPI 1093721714

Jacqueline Gaillard Gibson, PA-C's National Provider Identifier is 1093721714, issued on Aug 1, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Raleigh, NC. The record was last updated on Jul 8, 2007.