Healthcare Provider Details

I. General information

NPI: 1427680974
Provider Name (Legal Business Name): RACHAEL ANN GILBERT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TRILLIUM WAY
CORBIN KY
40701-8727
US

IV. Provider business mailing address

PO BOX 2623
LONDON KY
40743-2623
US

V. Phone/Fax

Practice location:
  • Phone: 606-523-1934
  • Fax:
Mailing address:
  • Phone: 606-224-7542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3014283
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: