| Doctor Name: | SUSAN DENNIE GIBBLE |
| NPI Number: | 1417025750 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 100726 |
| Business Practice Address: | 16 Medical Center Dr Supply, NC - 284623350 |
| Business Phone Number: | 9107548921 |
| Business Fax Number: | 9107547140 |
| Mailing Address: | 16 Medical Center Dr, SUPPLY |
| State: | NC |
| Postal Code: | 284623350 |
| Phone Number: | 9107548921 |
| Fax Number: | 9107547140 |
| NPI Enumeration Date: | 12/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 100726 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |