Individual
TERI TAYLOR GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
975 E. THIRD ST, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 2930, INDIANAPOLIS, IN 46206-2930
(423) 892-5602
(855) 630-1300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN110128
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10091
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000901029A
—
GA
05
—
009947280
—
AL
01
—
3164049
BLUE CROSS BLUE SHIELD TN
TN
05
—
3631375
—
TN
01
—
430064690
RAILROAD MEDICARE
TN
05
—
8052091
—
NC
Enumeration date
12/11/2006
Last updated
11/21/2022
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