Healthcare Provider Details

I. General information

NPI: 1851686356
Provider Name (Legal Business Name): CHRISTINE J GILMORE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 OLD DOMINION BLVD
BEDFORD VA
24523-3285
US

IV. Provider business mailing address

PO BOX 6316
LYNCHBURG VA
24505-6316
US

V. Phone/Fax

Practice location:
  • Phone: 540-586-5429
  • Fax: 540-586-1481
Mailing address:
  • Phone: 434-485-8862
  • Fax: 434-485-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP01797
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number20240
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number01797
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024184118
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: