Provider Demographics
NPI:1093556896
Name:GIBSON, TAYLOR ARLENE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ARLENE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6902 RUSTIC GRASSLAND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-1536
Mailing Address - Country:US
Mailing Address - Phone:702-677-7785
Mailing Address - Fax:
Practice Address - Street 1:6902 RUSTIC GRASSLAND ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-1536
Practice Address - Country:US
Practice Address - Phone:702-677-7785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist