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Ms. Lawanda D Gibson, PRACTICALNURSE
Licensed Practical Nurse in Southfield, Michigan
NPI 1558990432

Lawanda D Gibson is a Licensed Practical Nurse based in Detroit, MI. Lawanda D Gibson practices in Southfield, MI and has the professional credentials of PRACTICALNURSE. The NPI Number for Lawanda D Gibson is 1558990432 and holds a License No. 166730 (Michigan).

The current practice location address for Lawanda D Gibson is 21415 Civic Center Dr Ste 302, Southfield, MI and can be reached out via phone at 484-202-7023.

Location: 21415 Civic Center Dr Ste 302, Southfield, MI, 48223-1344
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558990432
Provider Name
Lawanda D Gibson
Credential
PRACTICALNURSE
Provider Entity Type
Individual
Gender
Female
Address
21415 Civic Center Dr Ste 302, Southfield, MI, 48223-1344
Phone Number
484-202-7023
Fax Number
Provider Enumeration Date
04/03/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
G125488135293 01 MI MI STATE DRIVERS LICENSE
institution
Provider Business Practice Location Address Details
Address
21415 Civic Center Dr Ste 302
City
Southfield
State
Michigan
Zip
48076-3954
Phone Number
484-202-7023
Fax Number
person
Provider Business Mailing Address Details
Address
21415 Civic Center Dr Ste 302
City
Southfield
State
Michigan
Zip
48076-3954
Phone Number
484-202-7023
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
166730 (Ohio)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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