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Individual

ANGELA RAE GIBBAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1221 S GEAR AVE, WEST BURLINGTON, IA 52655-1679
(319) 768-1000
(319) 768-3460
Mailing address
PO BOX 540, WEST BURLINGTON, IA 52655-0540
(319) 768-1000
(319) 768-3460

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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