Individual provider · Type 1 NPI

Edward Brooke Gibson Ii, CPNP-AC

Pediatric Nurse Practitioner · Philadelphia, PA

NPI number 1790305944 Active

Practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Call (800) 879-2467 Map

Mailing address

214 W Brookhaven Rd
Brookhaven, PA 19015-1638

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200XSP021857 (PA)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1790305944

Edward Brooke Gibson Ii, CPNP-AC's National Provider Identifier is 1790305944, issued on Apr 17, 2020. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 17, 2020.