Provider Demographics
NPI:1811554587
Name:GILMORE, ANNA CHRISTINE (DEM)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CHRISTINE
Last Name:GILMORE
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2793 CHEYENNE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81503-2874
Mailing Address - Country:US
Mailing Address - Phone:970-216-7849
Mailing Address - Fax:970-549-8259
Practice Address - Street 1:600 ROOD AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2760
Practice Address - Country:US
Practice Address - Phone:970-216-7849
Practice Address - Fax:970-549-8259
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMWR.0000196176B00000X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT06101981201938OtherTHIS IS A NUMBER I CREATED FOR MYSELF