Provider Demographics
NPI:1760131908
Name:GILBERT, ALIVA (APRN, CNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ALIVA
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:APRN, CNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 MIFFLIN AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-8848
Mailing Address - Country:US
Mailing Address - Phone:419-281-4440
Mailing Address - Fax:
Practice Address - Street 1:2212 MIFFLIN AVE STE 215
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-8846
Practice Address - Country:US
Practice Address - Phone:419-281-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030781363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health