Provider Demographics
NPI:1760542252
Name:BABCOCK GILL, LAUREL JEAN (NP)
Entity Type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:JEAN
Last Name:BABCOCK GILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:LAUREL
Other - Middle Name:JEAN
Other - Last Name:BABCOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN NP
Mailing Address - Street 1:5651 MARSHALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-2723
Mailing Address - Country:US
Mailing Address - Phone:714-846-5183
Mailing Address - Fax:
Practice Address - Street 1:1250 BELLFLOWER BLVD
Practice Address - Street 2:SHS
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90840-0201
Practice Address - Country:US
Practice Address - Phone:562-985-5146
Practice Address - Fax:562-985-8404
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN372597363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner