Provider Demographics
NPI:1740215623
Name:GILBERT, LAURA MARIE (CNM)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 E MADISON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-3938
Mailing Address - Country:US
Mailing Address - Phone:574-534-8771
Mailing Address - Fax:574-534-8774
Practice Address - Street 1:113 E MADISON ST
Practice Address - Street 2:SUITE B
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-3938
Practice Address - Country:US
Practice Address - Phone:574-534-8771
Practice Address - Fax:574-534-8774
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN72000064A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife