Provider Demographics
NPI:1285292003
Name:GIBSON, COURTNEY ELIZABETH (MSN , APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MSN , APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S WHEELING AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5631
Mailing Address - Country:US
Mailing Address - Phone:918-748-7600
Mailing Address - Fax:918-403-6316
Practice Address - Street 1:1919 S WHEELING AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5631
Practice Address - Country:US
Practice Address - Phone:918-748-7600
Practice Address - Fax:918-403-6316
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily