Individual
ANGELA RAE GIBBAR
Active
Individual
ANGELA RAE GIBBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D119292
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326212325
WELLMARK BLUE CROSS BLUE SHIELD
IA
05
—
1326212325
—
IA
01
—
P00623366
RR MEDICARE
IA
Enumeration date
04/22/2008
Last updated
12/04/2008
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