Individual
MR. NATHANIEL JAMES GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3311
Mailing address
4550 NICKLAUS DR APT 107, CHAMPAIGN, IL 61822-1507
(217) 369-7916
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.026720
IL
Other
Enumeration date
01/25/2023
Last updated
08/28/2025
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