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NPI Code Detail

MEDICARE: ELIZABETH VIRGINIA GILBERT FNP

MEDICARE:   ELIZABETH VIRGINIA GILBERT  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN041761AZ

General Provider Information

NPI Number : 1316081359
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH VIRGINIA GILBERT FNP
Provider Business Mailing Address
First Line : 6102 W MICHELLE DR
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-1113
Country : US
Telephone Number : 602-978-6069
Fax Number :
Provider Business Practice Location Address
First Line : 3300 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-3030
Country : US
Telephone Number : 480-510-6084
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 07/08/2007

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