Provider Demographics
NPI:1659131928
Name:GILBERT, STACY KATHLEEN (AGNP)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:KATHLEEN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:MRS
Other - First Name:STACY
Other - Middle Name:K
Other - Last Name:GILBERT-WILKERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:362 GRAMMER HILL RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-9025
Mailing Address - Country:US
Mailing Address - Phone:615-568-3605
Mailing Address - Fax:
Practice Address - Street 1:1272 GARRISON DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2598
Practice Address - Country:US
Practice Address - Phone:615-867-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN350972084N0400X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology