IndividualActive
Lillie Gibson, RN
NPI 1609321025 · School Registered Nurse · Grenada, MS
Provider details
- NPI number
- 1609321025
- Entity type
- Individual
- Primary specialty
- School Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- License
- R704695 (AR)
Specialties & taxonomies
Nursing Service Providers
Practice location
250 Pender Dr
Grenada, MS 38901-9312
Phone: (662) 226-8900
Fax: (662) 226-5767
Approximate (ZIP-level) locationGet directions
Mailing address
250 Pender Dr
Grenada, MS 38901-9312
Registry dates
- Enumerated
- 2016-08-16
- Last updated
- 2016-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.