Provider Demographics
NPI:1477448678
Name:GILDERSLEEVE, BIANCA (RN)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:GILDERSLEEVE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 DELANEY DR
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7100
Mailing Address - Country:US
Mailing Address - Phone:251-604-5416
Mailing Address - Fax:
Practice Address - Street 1:936 DELANEY DR
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7100
Practice Address - Country:US
Practice Address - Phone:251-604-5416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-148268163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice