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General NPI Number Information
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NPI Number | 1518088640
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Entity Type | Individual
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Provider Name | LILLA WD GILBERT CNP
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 175 ROADRUNNER PKWY
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City | LAS CRUCES
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State | NM
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Zip | 88011-5235
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Country | US
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Telephone | 505-413-3719
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Fax |
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Provider Business Mailing Address
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Address Line | 7683 SE 27TH ST #351
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City | MERCER ISLAND
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State | WA
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Zip | 98040
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Country | US
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Telephone | 505-413-3719
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | NP-05114
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 78977
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License Number State | NM
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