Provider Demographics
NPI:1295284156
Name:GILKEY, LAUREN KRISAK (RPA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KRISAK
Last Name:GILKEY
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:E
Other - Last Name:KRISAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:4101 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13066-6600
Mailing Address - Country:US
Mailing Address - Phone:315-637-7878
Mailing Address - Fax:315-624-1948
Practice Address - Street 1:4000 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 101 D
Practice Address - City:FAYETTEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13066-6600
Practice Address - Country:US
Practice Address - Phone:315-637-7878
Practice Address - Fax:315-744-1905
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant