Provider Demographics
NPI:1194538116
Name:GIBSON, KRISTA (BSN, RN)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N FRENCH AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1317
Mailing Address - Country:US
Mailing Address - Phone:360-618-6380
Mailing Address - Fax:
Practice Address - Street 1:18821 CROWN RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-4015
Practice Address - Country:US
Practice Address - Phone:360-618-6315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00142914163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool