Provider Demographics
NPI:1134407125
Name:GILCHRIST, BETH R (ANP-C)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:R
Last Name:GILCHRIST
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:FORT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-907-8922
Mailing Address - Fax:910-907-6069
Practice Address - Street 1:CLARK HEALTH CLINIC 5-4257 BASTOGNE ST
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-3629
Practice Address - Country:US
Practice Address - Phone:910-907-2575
Practice Address - Fax:910-907-9606
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA-12460-ANP363LA2200X
OHCOA.12460-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA-12460-NPOtherLICENSE