Gibson, Angela Goodwin

Gibson, Angela Goodwin is an individual health care provider with primary practice located at 1500 E., Woodrow Wilson Dr Jackson Va Medical Center, Jackson MS 39216. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Gibson, Angela Goodwin can be contacted via phone (601) 362-4471.

Contact Information

Primary practice address
1500 E., Woodrow Wilson Dr Jackson Va Medical Center Jackson MS 39216
Phone: (601) 362-4471
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R623334 Mississippi

Profile Details

NPI number 1164434163
LBN Legal business name Gibson, Angela Goodwin
Credentials APMH-NP BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Jul 2nd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164434163 NPPES
Mississippi MEDICAID 03108385

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