Gibson, Loretta Miner

Gibson, Loretta Miner is an individual health care provider with primary practice located at 14145 Southwood Dr , Fontana CA 92337-2724. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Gibson, Loretta Miner can be contacted via phone (909) 268-5549.

Contact Information

Primary practice address
14145 Southwood Dr Fontana CA 92337-2724
Phone: (909) 268-5549
Fax: (909) 363-7416
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X NA3135 California

Profile Details

NPI number 1629053525
LBN Legal business name Gibson, Loretta Miner
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jun 24th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629053525 NPPES
California MEDICAID RN3686700

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