Provider Demographics
NPI:1194101485
Name:GIBSON, WILLIAM SCOTT (APRN PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:GIBSON
Suffix:
Gender:M
Credentials:APRN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 E LEXINGTON AVE STE 30
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1707
Mailing Address - Country:US
Mailing Address - Phone:859-209-2198
Mailing Address - Fax:859-209-4439
Practice Address - Street 1:1000 E LEXINGTON AVE STE 30
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1707
Practice Address - Country:US
Practice Address - Phone:859-209-2198
Practice Address - Fax:859-209-4439
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3009625363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health