Black, Gloria Gilbert

Black, Gloria Gilbert is an individual health care provider with primary practice located at 3600 Joseph Siewick Dr , Fairfax VA 22033-1709. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Black, Gloria Gilbert can be contacted via phone (703) 295-9360.

Contact Information

Primary practice address
3600 Joseph Siewick Dr Fairfax VA 22033-1709
Phone: (703) 295-9360
Fax: (703) 295-9369
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 0024076529 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 0024076529 Virginia

Profile Details

NPI number 1003815267
LBN Legal business name Black, Gloria Gilbert
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Feb 21st, 2019 - about 5 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1003815267 NPPES
Virginia MEDICAID 1003815267
Virginia Other 296621
Virginia Other K142-0002
Virginia Other 139180

Popular Providers