Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jacqueline Gaillard Gibson, PA-C

Individual provider Medical Physician Assistant · NPI 1093721714

Mrs. Jacqueline Gaillard Gibson, PA-C is a Physician Assistant in Raleigh, North Carolina. Qualified in 2003, 23 years ago. Practices with County of Wake, a 19-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
23
Licensed in
NC
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

820 S Boylan Ave
Raleigh, NC 27603-2246
Phone: (919) 733-0740
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 103859 (NC)

Record details

NPI number1093721714
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 1, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice County Of Wake — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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