Provider Demographics
NPI:1093512352
Name:GIBSON, CHERI
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:GIBSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 CHARMED OASIS CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-3008
Mailing Address - Country:US
Mailing Address - Phone:702-517-8595
Mailing Address - Fax:702-517-8595
Practice Address - Street 1:2408 CHARMED OASIS CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-3008
Practice Address - Country:US
Practice Address - Phone:702-517-8595
Practice Address - Fax:702-517-8595
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant