Provider Demographics
NPI:1083305809
Name:GILMERE, KAITLIN ELAINE (CNA)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:ELAINE
Last Name:GILMERE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 APPLETON ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-2547
Mailing Address - Country:US
Mailing Address - Phone:978-401-1042
Mailing Address - Fax:
Practice Address - Street 1:226 APPLETON ST UNIT 3
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2547
Practice Address - Country:US
Practice Address - Phone:978-401-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA$$$$$$$$$251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care