MRS. ALYCIA D GIBSON (NPI# 1073544516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073544516 |
| Entity Type | Individual |
| Full Name | MRS. ALYCIA D GIBSON |
| Credential | PAC |
| Practice Address |
405 Tyson Ave Ste B Grace Clinic, Inc Paris TN 38242-4836 |
| Mailing Address |
4407 Highway 140 S Mc Kenzie TN 38201-5121 |
| Practice Telephone | 7316443339 |
| Practice Fax Number | 7316449930 |
| Mailing Telephone | 7312434826 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2013-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0000001274 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1515861 | 05 | |
| TN | CLIA | 44D2000904 | 01 |
| Street Address |
405 TYSON AVE STE B GRACE CLINIC, INC |
| City | PARIS |
| State | TN |
| Zip Code | 38242-4836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396374732 | Renee Michelle Girouard | Physician Assistant | 209 B Tyson Ave, Paris, TN 38242 | 2020-04-07 |
| 1255960134 | Alexander P Patrone | Student in an Organized Health Care Education/Training Program | 302b Tyson Ave, Paris, TN 38242 | 2020-04-03 |
| 1457980302 | Aswathy Krishnakumar | Student in an Organized Health Care Education/Training Program | 302b Tyson Avenue, Paris, TN 38242 | 2020-04-03 |
| 1053824052 | Rocky Mountain Holdings, LLC | Ambulance | 1949 Driggs Road, Paris, TN 38242 | 2017-11-13 |
| 1588199152 | Taylor Wilson | Dentist | 3485 Highway 79 N, Paris, TN 38242 | 2017-04-20 |
| 1215472592 | Elizabeth Lane Mcintosh | Behavioral Analyst | 28 Fieldstone Dr, Paris, TN 38242 | 2016-12-22 |
| 1124574959 | Patty Wilson | Counselor | 2555 E. Wood Street, Paris, TN 38242 | 2016-08-31 |
| 1942601539 | Trustworthy Anesthesia Care | Nurse Anesthetist, Certified Registered | 1010 Green Hill Dr, Paris, TN 38242 | 2014-09-15 |
| 1083963946 | West Tennessee Physical Medicine, Pllc | General Practice | 1024 Mineral Wells Avenue, Paris, TN 38242 | 2012-09-06 |
| 1316242514 | Henry Co. Health Dept. | Skilled Nursing Facility | 803 Joy St., Paris, TN 38242 | 2011-01-19 |
| Find all providers in zip 38242 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134749922 | Mckenzie Jacobson | Physician Assistant | 302 Tyson Ave # B, Paris, TN 38242-4576 | 2020-04-21 |
| 1699742205 | Daphne Tracy Foust | Physician Assistant | 849 Volunteer Dr Ste 2, Paris, TN 38242-5483 | 2006-03-02 |
| 1760461016 | Lisa Dianne Hatch Hubbard | Physician Assistant | 706 E Wood St, Paris, TN 38242-4220 | 2006-01-14 |
| 1346247186 | Kerri Ann Mccabe Smith | Physician Assistant | 1015 Kelley Dr, Suite 200, Paris, TN 38242-5819 | 2005-07-07 |
| 1457843567 | Charles I Okafor | Physician Assistant | 301 Tyson Ave, Paris, TN 38242-4544 | 2018-06-04 |
| 1386004570 | Katherine Ann Chadwick | Physician Assistant | 865 Deshong Dr, Paris, TX 75460-9313 | 2016-03-01 |
| 1265717193 | Karen Elizabeth Thompson | Physician Assistant | 193 Jim Adams Dr, Paris, TN 38242-4965 | 2011-10-11 |
| 1346353372 | Lamar Emergency Group Pa | Physician Assistant | 820 Clarksville St, Paris, TX 75460-6027 | 2006-08-16 |
| 1740288349 | Kristopher Eugene Gulish | Physician Assistant | 1015 Kelley Dr, Suite 200, Paris, TN 38242-5819 | 2005-07-08 |
| 1568467165 | Rebecca Beaver Norment | Physician Assistant | 1055 Clarksville St, Ste 195, Paris, TX 75460-6097 | 2005-06-20 |
| Find all providers in PARIS | ||||
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| 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.