Individual
H.P. GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-2000
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 882-0705
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-065636
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
2992
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000029197
—
AL
01
—
173758061A
CAID GA
AL
01
—
430036750
PALMETTO
AL
Enumeration date
04/17/2006
Last updated
12/21/2016
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