Healthcare Provider Details

I. General information

NPI: 1013491281
Provider Name (Legal Business Name): MEREDITH H GILPIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1698 OLD LEBANON RD STE 3B
CAMPBELLSVILLE KY
42718-9662
US

IV. Provider business mailing address

1698 OLD LEBANON RD
CAMPBELLSVILLE KY
42718-9662
US

V. Phone/Fax

Practice location:
  • Phone: 270-789-2471
  • Fax: 270-465-4669
Mailing address:
  • Phone: 270-789-5822
  • Fax: 270-789-6119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2398
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: