Provider Demographics
NPI:1033743943
Name:GILBERT, MAGGIE CAMPBELL (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:CAMPBELL
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 890
Mailing Address - Street 2:
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-0890
Mailing Address - Country:US
Mailing Address - Phone:276-935-1481
Mailing Address - Fax:276-935-1219
Practice Address - Street 1:1535 SLATE CREEK RD
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614-6974
Practice Address - Country:US
Practice Address - Phone:276-935-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-29
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178955363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health