Provider Demographics
NPI:1326641630
Name:GILL, JOSEPH LINN (FNP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LINN
Last Name:GILL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 GEORGIA ST NE STE E4
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1388
Mailing Address - Country:US
Mailing Address - Phone:505-916-5128
Mailing Address - Fax:505-916-5128
Practice Address - Street 1:3901 GEORGIA ST NE STE E4
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1388
Practice Address - Country:US
Practice Address - Phone:505-916-5128
Practice Address - Fax:505-916-5128
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM62549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily