Simon Jack Gibson, DNP, CRNA
Nurse Anesthetist, Certified Registered in Chattanooga, TN. Individual provider (NPI-1).
NPI number1982140844
StatusActive
Last updated in NPPESAug 16, 2022
Details
- NPI
- 1982140844
- Entity type
- Individual (NPI-1)
- Name
- Simon Jack Gibson
- Credential
- DNP, CRNA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 16, 2017
- Certification date
- Aug 16, 2022
- Last updated
- Aug 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | GAA-CRNA000891 | GA | Yes |
| 163W00000X | Registered Nurse | 877434 | MS |
Practice location
8915 Potomac DrChattanooga, TN 37421-2008
Phone 601-826-9031
Mailing address
410 N Cedar Bluff RdSte 300
Knoxville, TN 37923-3632
Phone 865-342-8900 · Fax 865-691-0843
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