Provider Demographics
NPI:1841623402
Name:GILBERT, BRANDI L (NP)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:L
Last Name:GILBERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 SUNFOREST CT SUITE 202
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4231
Mailing Address - Country:US
Mailing Address - Phone:419-725-3300
Mailing Address - Fax:
Practice Address - Street 1:3949 SUNFOREST CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4473
Practice Address - Country:US
Practice Address - Phone:419-725-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-17
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN323947363LF0000X
OHCOA15019NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0091377Medicaid
OHRN323947OtherMEDICAL LICENSE
OH0091377Medicaid