Provider Demographics
NPI:1184837700
Name:GILBERT, KATIE K (APN)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:K
Last Name:GILBERT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 AVENUE F N
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3167
Mailing Address - Country:US
Mailing Address - Phone:979-245-2008
Mailing Address - Fax:979-245-0744
Practice Address - Street 1:1700 GOLDEN AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3122
Practice Address - Country:US
Practice Address - Phone:979-245-2008
Practice Address - Fax:979-245-0744
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX696853363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350305402Medicaid
12203535OtherCAQH
9843799OtherAETNA HEALTH INSURANCE
TXH08382NR01OtherBCBS OF TX