Healthcare Provider Details

I. General information

NPI: 1386774099
Provider Name (Legal Business Name): BRENDA GILPATRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 GUFFEY ST TN DEPT. OF HEALTH
CELINA TN
38551-4089
US

IV. Provider business mailing address

1160 LIVINGSTON HWY
CELINA TN
38551-3507
US

V. Phone/Fax

Practice location:
  • Phone: 931-243-2651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: