Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APN12278 | TN |
NPI | 1003033259 |
---|---|
Provider Name | Cindy T Gilbert |
First Address | Chattanooga, TN 37405-2645 |
Second Address | Chattanooga, TN 37405-2645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P57407 | (02) | TN |