Provider Demographics
NPI:1336874361
Name:RITA K GILL MS CRNP CERTIFIED REGISTERED NURSING CORPORATION
Entity Type:Organization
Organization Name:RITA K GILL MS CRNP CERTIFIED REGISTERED NURSING CORPORATION
Other - Org Name:RITA GILL, PMHNP, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:916-705-0593
Mailing Address - Street 1:2064 PETRUCHIO WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3221
Mailing Address - Country:US
Mailing Address - Phone:916-705-0593
Mailing Address - Fax:
Practice Address - Street 1:1400 EXPO PKWY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4230
Practice Address - Country:US
Practice Address - Phone:916-437-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty