MS. LAWANDA D GIBSON (NPI# 1558990432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558990432 |
| Entity Type | Individual |
| Full Name | MS. LAWANDA D GIBSON |
| Other Name | MS. LAWANDA DASHAWN GIBSON |
| Credential | PRACTICAL NURSE |
| Practice Address |
21415 Civic Center Dr Ste 302 Southfield MI 48076-3954 |
| Mailing Address |
19240 Gainsborough Rd Detroit MI 48223-1344 |
| Practice Telephone | 4842027023 |
| Mailing Telephone | 3135649996 |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2020-04-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | 166730 | OH | Nursing Service Providers |
| Y | 164W00000X | Licensed Practical Nurse | 4703119637 | MI | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MI STATE DRIVERS LICENSE | G125488135293 | 01 |
| Street Address |
21415 CIVIC CENTER DR STE 302 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48076-3954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813753 | Elaine Sarah Kahn | Social Worker | 15999 West Twelve Mile Rd, Southfield, MI 48076 | 2020-08-31 |
| 1295353829 | Marian Hannah Ibrahim | Dentist | 19189 W 12 Mile Rd, Lathrup Village, MI 48076 | 2020-07-09 |
| 1699317669 | Meadow Lane Rehabilitative Therapies LLC | Social Worker | 29895 Greenfield Rd., Suite 104b, Southfield, MI 48076 | 2019-10-11 |
| 1760035752 | Taliah Laneice Williams-hunter | Counselor | 30119 Sparkleberry Dr., Southfield, MI 48076 | 2019-07-19 |
| 1386114742 | Mavis Gail Pookrum | Technician | 21732 Colony Park Circle #105, Southfield, MI 48076 | 2018-11-28 |
| 1861962417 | Millennial Infusion Centers Inc | Clinic/Center | 26250 Northwestern Hwy Ste 201, Southfield, MI 48076 | 2018-11-27 |
| 1215429212 | Debra Deanes | Counselor | 30233 Southfiels Rd, 203, Southfield, MI 48076 | 2018-06-05 |
| 1437675758 | Kenneth Gerard Giles | Counselor | 29532 Southfield Rd. Suite 208, Southfield, MI 48076 | 2017-08-17 |
| 1902346836 | Linsk Psychiatry Services P C | Clinic/Center | 21751 W 12 Mile Rd, Suite 205, Southfield, MI 48076 | 2017-02-25 |
| 1023552361 | Massage Serenity | Community/Behavioral Health | 20245 W. 12 Mile Rd, Suite 113, Southfield, MI 48076 | 2016-12-06 |
| Find all providers in zip 48076 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| 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. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789546 | Lashonda S Noble | Licensed Practical Nurse | 21107 Lahser Rd, Southfield, MI 48033-4400 | 2020-10-30 |
| 1376102434 | Dajuan Fanning | Licensed Practical Nurse | 17072 New Hampshire Dr, Southfield, MI 48075-2972 | 2019-06-11 |
| 1306409404 | Rochelle L Smith | Licensed Practical Nurse | 26748 Franklin Pointe Dr, Southfield, MI 48034-5626 | 2019-04-16 |
| 1063972800 | Amicah Desiray Tolbert | Licensed Practical Nurse | 17608 Gateway Cir, Southfield, MI 48075-4718 | 2019-03-20 |
| 1396211884 | Carolyn Burroughs | Licensed Practical Nurse | 26962 Franklin Rd Apt 131, Southfield, MI 48033-2437 | 2018-10-23 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1558863308 | Taqayla Allie | Licensed Practical Nurse | 23870 Lawn Rd Apt 2104, Southfield, MI 48033-3138 | 2018-03-07 |
| 1003322637 | Crystal Young-rowe | Licensed Practical Nurse | 19800 Saxton Ave, Southfield, MI 48075-7330 | 2017-12-19 |
| 1851807440 | Jasmine Nelson | Licensed Practical Nurse | 25597 Ingleside Dr, Southfield, MI 48033-4842 | 2017-12-19 |
| 1811429244 | Sandra Dee Wolfe | Licensed Practical Nurse | 21271 8 1/2 Mile Rd, Southfield, MI 48075-3876 | 2017-04-03 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48076 |
Please comment or provide details below to improve the information on MS. LAWANDA D GIBSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.