Individual
MRS. GLORIA GILBERT BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3600 JOSEPH SIEWICK DR, FAIRFAX, VA 22033-1709
(703) 295-9360
(703) 295-9369
Mailing address
PO BOX 37090, BALTIMORE, MD 21297-3090
(703) 295-9360
(703) 295-9369
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0024076529
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024076529
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003815267
—
VA
01
—
139180
ANTHEM
VA
01
—
296621
AMERIGROUP
VA
01
—
K142-0002
CAREFIRST
VA
Enumeration date
07/19/2005
Last updated
02/21/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us