Healthcare Provider Details

I. General information

NPI: 1578853339
Provider Name (Legal Business Name): LORI ANN GEBELL CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6862 E FIELDSTONE LN
TUCSON AZ
85750-2077
US

IV. Provider business mailing address

6862 E FIELDSTONE LN
TUCSON AZ
85750-2077
US

V. Phone/Fax

Practice location:
  • Phone: 214-227-2457
  • Fax: 214-764-0880
Mailing address:
  • Phone: 214-227-2457
  • Fax: 214-764-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN152203
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: