Individual
AMANDA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
(602) 344-0779
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5043
(602) 470-5064
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1177
AZ
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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