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NPI Code Detail

MEDICARE: RITA K GILL MS CRNP CERTIFIED REGISTERED NURSING CORPORATION

MEDICARE: RITA K GILL MS CRNP CERTIFIED REGISTERED NURSING CORPORATION
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1336874361
Entity Type Code : Organization
Provider Name (Legal Business Name) : RITA K GILL MS CRNP CERTIFIED REGISTERED NURSING CORPORATION
Provider Business Mailing Address
First Line : 2064 PETRUCHIO WAY
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3221
Country : US
Telephone Number : 916-705-0593
Fax Number :
Provider Business Practice Location Address
First Line : 1400 EXPO PKWY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95815-4230
Country : US
Telephone Number : 916-437-6400
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. RITA GILL
Credential : PMHNP
Telephone Number : 916-705-0593
Provider Enumeration Date : 07/22/2022
Last Update Date : 11/22/2022

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