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General NPI Number Information
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NPI Number | 1477101038
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Entity Type | Individual
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Provider Name | MICHELLE R GILMORE FNP
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Gender | Female
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 4435 AICHOLTZ RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45263-5353
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Country | US
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Telephone | 513-947-0400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 639295 DEPT 93394
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City | CINCINNATI
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State | OH
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Zip | 45263-9295
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Country | US
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Telephone | 482-664-2002
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5012170
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4011685
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0031395
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License Number State | OH
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