Provider Demographics
NPI:1669021523
Name:GILBERT, CARLA DEANNE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:DEANNE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:100 LONDON MOUNTAIN VIEW DR STE B
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-6668
Practice Address - Country:US
Practice Address - Phone:606-330-4880
Practice Address - Fax:606-330-4881
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily