Healthcare Provider Details

I. General information

NPI: 1457865966
Provider Name (Legal Business Name): TAMARA GILBERT MSN, RN, ARNP, MSCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 07/22/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 CHURCH ST STE B
HIAWASSEE GA
30546-3223
US

IV. Provider business mailing address

360 RIVER COVE LN
HAYESVILLE NC
28904-9411
US

V. Phone/Fax

Practice location:
  • Phone: 706-896-5858
  • Fax: 706-896-5959
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number350774
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN276934
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPN.0993448-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: