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General NPI Number Information
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NPI Number | 1316157027
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Entity Type | Individual
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Provider Name | JULIE MICHELLE GILMORE CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 920 CHURCH ST N
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City | CONCORD
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State | NC
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Zip | 28025-2927
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Country | US
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Telephone | 704-783-4339
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Fax |
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Provider Business Mailing Address
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Address Line | 429 RIDGEWAY AVE
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City | CHARLOTTE
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State | NC
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Zip | 28204-2731
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Country | US
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Telephone | 704-965-0093
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 162270
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License Number State | NC
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