Provider Demographics
NPI:1629461744
Name:GILBERT, LAURIEANN MICHELLE (FNP)
Entity Type:Individual
Prefix:
First Name:LAURIEANN
Middle Name:MICHELLE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32667 WILLOWVAIL CIR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1854
Mailing Address - Country:US
Mailing Address - Phone:805-234-5979
Mailing Address - Fax:
Practice Address - Street 1:12900 FREDERICK ST
Practice Address - Street 2:C
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-5266
Practice Address - Country:US
Practice Address - Phone:888-743-7526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA825935163W00000X
CA95001972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse