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General NPI Number Information
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NPI Number | 1184106098
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Entity Type | Individual
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Provider Name | KATHRYN JEAN GILL AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 4515 FALLS OF NEUSE RD STE 420
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City | RALEIGH
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State | NC
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Zip | 27609-6374
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Country | US
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Telephone | 919-877-9959
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Fax |
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Provider Business Mailing Address
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Address Line | 325 SILVER MAPLE DR
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-4544
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Country | US
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Telephone | 774-392-4125
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Fax | 470-221-1650
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5016516
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN276387
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License Number State | MA
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