Provider Demographics
NPI:1548237225
Name:WATSON, GILBERT J (CRNA)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:J
Last Name:WATSON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9260 W SUNSET RD
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4903
Mailing Address - Country:US
Mailing Address - Phone:402-489-4186
Mailing Address - Fax:402-489-5279
Practice Address - Street 1:2900 S 70TH ST STE 450
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3796
Practice Address - Country:US
Practice Address - Phone:402-489-4186
Practice Address - Fax:402-489-5279
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCRNA000261367500000X
NENE100472367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47061979815Medicaid
NER29782Medicare UPIN
NE272294Medicare PIN