Provider Demographics
NPI:1417092420
Name:GILL, KATHERINE LOUISE
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LOUISE
Last Name:GILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 L ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-1935
Mailing Address - Country:US
Mailing Address - Phone:907-271-6728
Mailing Address - Fax:907-271-2665
Practice Address - Street 1:510 L ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-1935
Practice Address - Country:US
Practice Address - Phone:907-271-6728
Practice Address - Fax:907-271-2665
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
24720000X247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other