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NPI Code Detail

MEDICARE: MRS. SUSAN MARIE GILBERT FNP

MEDICARE: MRS. SUSAN MARIE GILBERT FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner5009822NC

General Provider Information

NPI Number : 1255858056
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN MARIE GILBERT FNP
Provider Business Mailing Address
First Line : 2347 SIMONTON ROAD
Second Line :
City : STATESVILLE
State : NC
Zip : 28625-8246
Country : US
Telephone Number : 704-873-4719
Fax Number : 704-872-1810
Provider Business Practice Location Address
First Line : 2347 SIMONTON RD
Second Line :
City : STATESVILLE
State : NC
Zip : 28625-8246
Country : US
Telephone Number : 704-873-4719
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2017
Last Update Date : 08/30/2017

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