Provider Demographics
NPI:1104668763
Name:GIBSON, SARAH (PCT, AOT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:PCT, AOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 W ROBBINS RD
Mailing Address - Street 2:
Mailing Address - City:ROBBINS
Mailing Address - State:TN
Mailing Address - Zip Code:37852-3323
Mailing Address - Country:US
Mailing Address - Phone:423-223-1809
Mailing Address - Fax:
Practice Address - Street 1:1815 W ROBBINS RD
Practice Address - Street 2:
Practice Address - City:ROBBINS
Practice Address - State:TN
Practice Address - Zip Code:37852-3323
Practice Address - Country:US
Practice Address - Phone:423-223-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health