Provider Demographics
NPI:1528872223
Name:GIBSON, HANNAH QUIRIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:QUIRIE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 BROADWAY APT 22
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-5426
Mailing Address - Country:US
Mailing Address - Phone:206-504-4901
Mailing Address - Fax:
Practice Address - Street 1:532 BROADWAY APT 22
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5426
Practice Address - Country:US
Practice Address - Phone:206-504-4901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033775363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health