Individual
DEANNA MARY GISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
(417) 820-8852
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2011040587
MO
367500000X
Certified Registered Nurse Anesthetist
CTP-000120
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639409394
—
MO
05
—
185881001
—
AR
01
—
431560263
TRICARE
MO
01
—
P01059535
MCR - RR
MO
Enumeration date
12/31/2009
Last updated
11/28/2012
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