Provider Demographics
NPI:1255023982
Name:GIBSON PSYCH SERVICES
Entity type:Organization
Organization Name:GIBSON PSYCH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN, PSYCHIATRIC CNS
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-242-9532
Mailing Address - Street 1:11800 SINGLETREE LN STE 312
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5398
Mailing Address - Country:US
Mailing Address - Phone:612-440-6557
Mailing Address - Fax:612-500-4964
Practice Address - Street 1:11800 SINGLETREE LN STE 312
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-5398
Practice Address - Country:US
Practice Address - Phone:612-440-6557
Practice Address - Fax:612-500-4964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty