Provider Demographics
NPI:1134862501
Name:GILBERT, ALICIA B (RN)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:B
Last Name:GILBERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 AIRPORT CT STE B
Mailing Address - Street 2:
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-6196
Mailing Address - Country:US
Mailing Address - Phone:843-858-2918
Mailing Address - Fax:
Practice Address - Street 1:206 AIRPORT CT STE B
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-6196
Practice Address - Country:US
Practice Address - Phone:843-858-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251754163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health