GIBSON WELLNESS NPI 1881531499

NPI Information

  • NPI: 1881531499
  • Provider Name: GIBSON WELLNESS
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 11D2306613
  • Address: 143 US HWY 319 S, MOULTRIE, GA 31768, MOULTRIE, GA 3176
    UNIT 12
    MOULTRIE, GA
    ZIP 31768
  • Phone: (229) 985-0208

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NPI Details

GIBSON WELLNESS is a family nurse practitioner in Moultrie, GA. GIBSON WELLNESS NPI is 1881531499. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

143 US HWY 319 S, MOULTRIE, GA 31768, MOULTRIE, GA 3176
UNIT 12
MOULTRIE, GA
ZIP 31768
Phone: (229) 985-0208

The provider's authorized official is Tiffanie A Gibson .
The authorized official title is Owner and has the following contact phone number (229) 985-0208.

The CLIA number assigned to this NPI record is 11D2306613 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/1/2026 and was last updated on 5/1/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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