Individual
MRS. GLORIA GILBERT BLACK
Active
Individual
MRS. GLORIA GILBERT BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
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
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