Provider Demographics
NPI:1366738239
Name:FORBES, GIA R (CRNA)
Entity type:Individual
Prefix:
First Name:GIA
Middle Name:R
Last Name:FORBES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 DARLENE LN STE 201
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1601
Mailing Address - Country:US
Mailing Address - Phone:541-683-5488
Mailing Address - Fax:
Practice Address - Street 1:1125 DARLENE LN STE 201
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-1601
Practice Address - Country:US
Practice Address - Phone:541-683-5488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO100035367500000X
OR201903844CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered