Healthcare Provider Details

I. General information

NPI: 1295443364
Provider Name (Legal Business Name): COURTNEY GILBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 W MARKET ST STE 260
LIMA OH
45805-2745
US

IV. Provider business mailing address

825 W MARKET ST STE 260
LIMA OH
45805-2745
US

V. Phone/Fax

Practice location:
  • Phone: 567-940-5300
  • Fax: 567-940-9600
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0035665
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR253001
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: