Provider Demographics
NPI:1891146304
Name:GILL, ELIZABETH ANN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:GILL
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:2921 TELESTAR CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1205
Practice Address - Country:US
Practice Address - Phone:703-280-5858
Practice Address - Fax:703-849-0874
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2021-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110840797363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant