Provider Demographics
NPI:1164194429
Name:GILMER, LAURA GENEVA (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:GENEVA
Last Name:GILMER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2804
Mailing Address - Country:US
Mailing Address - Phone:256-826-1001
Mailing Address - Fax:256-978-5118
Practice Address - Street 1:210 AVALON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2804
Practice Address - Country:US
Practice Address - Phone:256-826-1001
Practice Address - Fax:256-978-5118
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-124928363LF0000X, 363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health