MEDICARE: KRISTINA GILBERT APRN

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
1	363L00000X	Nurse Practitioner	3005971	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000787146	OTHER	KY	ANTHEM BC/BS
2	50042936	OTHER	KY	PASSPORT
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629222070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA GILBERT APRN

Provider Business Mailing Address
First Line	:	PO BOX 776351
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6351
Country	:	US
Telephone Number	:	502-272-5754
Fax Number	:	502-272-5339

Provider Business Practice Location Address
First Line	:	1230 MARKET ST
Second Line	:
City	:	LA GRANGE
State	:	KY
Zip	:	40031-7986
Country	:	US
Telephone Number	:	502-225-6900
Fax Number	:	502-666-7693

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2008
Last Update Date	:	08/28/2024

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Directions to “ KRISTINA GILBERT APRN” Practice Location

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