Individual
LORETTA MINER GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
14145 SOUTHWOOD DR, FONTANA, CA 92337-2724
(909) 268-5549
(909) 363-7416
Mailing address
14145 SOUTHWOOD DR, FONTANA, CA 92337-2724
(909) 268-5549
(909) 363-7416
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA3135
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN3686700
—
CA
Enumeration date
12/13/2005
Last updated
06/24/2011
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