Provider Demographics
NPI:1508599739
Name:GILBERT, ADRIAN (RN, CRNA)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:GILBERT
Suffix:
Gender:M
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4370 S TWIN PEAKS DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-0992
Mailing Address - Country:US
Mailing Address - Phone:575-520-1297
Mailing Address - Fax:
Practice Address - Street 1:4141 AMBASSADOR DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5928
Practice Address - Country:US
Practice Address - Phone:907-729-3973
Practice Address - Fax:907-729-1542
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK189759163W00000X
AK195389367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse