Provider Demographics
NPI:1699728519
Name:HIBYAN, ZOE INGALIS (CRNA)
Entity type:Individual
Prefix:MRS
First Name:ZOE
Middle Name:INGALIS
Last Name:HIBYAN
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:PO BOX 30423
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1423
Mailing Address - Country:US
Mailing Address - Phone:850-471-0707
Mailing Address - Fax:850-478-7377
Practice Address - Street 1:9400 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5752
Practice Address - Country:US
Practice Address - Phone:850-471-0707
Practice Address - Fax:850-478-7377
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2086612367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL59118727OtherBLUE CROSS BLUE SHIELD
AL009977055Medicaid
FL301168200Medicaid
FLP00169232OtherMEDICARE RAILROAD
FLG1186OtherBLUE CROSS BLUE SHIELD
FLP00169232OtherMEDICARE RAILROAD