Healthcare Provider Details

I. General information

NPI: 1134898943
Provider Name (Legal Business Name): JILL LAURESE GILBERT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL LAURESE HUDSON-GILBERT RN

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7154 MEDICAL CENTER DR
SPRING HILL FL
34608-1329
US

IV. Provider business mailing address

4371 VERONICA S SHOEMAKER BLVD
FORT MYERS FL
33916-2216
US

V. Phone/Fax

Practice location:
  • Phone: 352-596-1926
  • Fax: 352-320-2154
Mailing address:
  • Phone: 239-432-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License NumberAPRN11015230
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11015230
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11015230
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: