Individual
TAMMY MICHELLE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 882-2568
(573) 882-2226
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
133170
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
2006036516
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127254
BLUE SHIELD
MO
01
—
769513
HEALTHLINK
MO
05
—
8052158
—
NC
05
—
917535403
—
MO
Enumeration date
08/31/2006
Last updated
08/23/2022
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