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General NPI Number Information
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NPI Number | 1285474866
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Entity Type | Individual
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Provider Name | ALEXA NICOLE GILMORE FNP
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Gender | Female
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 7 VILLAGE SQ
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City | CHELMSFORD
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State | MA
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Zip | 01824-2712
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Country | US
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Telephone | 978-256-4363
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Fax |
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Provider Business Mailing Address
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Address Line | 18 WHEELWRIGHT RD
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City | MEDFORD
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State | MA
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Zip | 02155-2239
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Country | US
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Telephone | 617-435-8509
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN2316846
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License Number State | MA
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