Provider Demographics
NPI:1609215789
Name:KILGORE, PRISCILLA HOPE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:HOPE
Last Name:KILGORE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:164 BEAVER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-5808
Mailing Address - Country:US
Mailing Address - Phone:478-678-5448
Mailing Address - Fax:844-280-7803
Practice Address - Street 1:435 2ND ST
Practice Address - Street 2:SUITE 430
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8298
Practice Address - Country:US
Practice Address - Phone:478-745-5779
Practice Address - Fax:478-742-7796
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN131629363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily