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General NPI Number Information
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NPI Number | 1891555280
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Entity Type | Individual
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Provider Name | GILBERT CHIRSTOPHER JARAMILLO III PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 300 EAST HOSPITAL ROAD
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City | FORT EISENHOWER
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State | GA
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Zip | 30905
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Country | US
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Telephone | 254-630-4561
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Fax |
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Provider Business Mailing Address
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Address Line | 483 CAMBRIDGE WAY
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City | MARTINEZ
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State | GA
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Zip | 30907-8943
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Country | US
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Telephone | 254-630-4561
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 78180
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License Number State | NM
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