Healthcare Provider Details

I. General information

NPI: 1548237225
Provider Name (Legal Business Name): GILBERT J WATSON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 S 70TH ST STE 450
LINCOLN NE
68506-3796
US

IV. Provider business mailing address

9260 W SUNSET RD STE 200
LAS VEGAS NV
89148-4903
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-4186
  • Fax: 402-489-5279
Mailing address:
  • Phone: 402-489-4186
  • Fax: 402-489-5279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA000261
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNE100472
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: