Provider Demographics
NPI:1316227366
Name:GILBERT, DONNA G (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:G
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GILBERT RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-9454
Mailing Address - Country:US
Mailing Address - Phone:607-351-3909
Mailing Address - Fax:
Practice Address - Street 1:25 GILBERT RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-9454
Practice Address - Country:US
Practice Address - Phone:607-351-3909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090128-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse