Mrs Gloria Gilbert Black, CRNA | |
3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | |
(703) 295-9360 | |
(703) 295-9369 |
Full Name | Mrs Gloria Gilbert Black |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 38 Years |
Location | 3600 Joseph Siewick Dr, Fairfax, Virginia |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003815267 | NPI | - | NPPES |
1003815267 | Medicaid | VA | |
296621 | Other | VA | AMERIGROUP |
K142-0002 | Other | VA | CAREFIRST |
139180 | Other | VA | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 0024076529 (Virginia) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 0024076529 (Virginia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Inova Fair Oaks Hospital | Fairfax, VA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Inova Cares - Community | 9537526330 | 201 |
Inova Cares - Community | 9537526330 | 201 |
Entity Name | American Anesthesiology Of Virginia Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417994872 PECOS PAC ID: 6800790023 Enrollment ID: O20031120000429 |
Entity Name | Inova Health Care Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952320061 PECOS PAC ID: 2466351093 Enrollment ID: O20040102000644 |
Entity Name | North American Partners In Anesthesia (virginia), Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922031442 PECOS PAC ID: 9931192739 Enrollment ID: O20040407000294 |
Entity Name | Inova Cares - Community |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861131906 PECOS PAC ID: 9537526330 Enrollment ID: O20230620001611 |
Mailing Address | Practice Location Address |
---|---|
Mrs Gloria Gilbert Black, CRNA Po Box 37090, Baltimore, MD 21297-3090 Ph: (703) 295-9360 | Mrs Gloria Gilbert Black, CRNA 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 Ph: (703) 295-9360 |