Provider Demographics
NPI:1881645653
Name:GILPIN, VICTORIA LOUISE (APRN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LOUISE
Last Name:GILPIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:L
Other - Last Name:HANRAHAN-KNAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7687
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-7687
Mailing Address - Country:US
Mailing Address - Phone:573-999-6117
Mailing Address - Fax:
Practice Address - Street 1:ONE HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65205-7687
Practice Address - Country:US
Practice Address - Phone:573-999-6117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN093448363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO425205606Medicaid
MO132292OtherBLUE SHIELD/BLUE CHOICE
KS4287232401OtherKANSAS MEDICAID
MO448349OtherHEALTHLINK
MO018080010Medicare PIN
R22179Medicare UPIN
MO132292OtherBLUE SHIELD/BLUE CHOICE
MO833825236Medicare PIN
KS4287232401OtherKANSAS MEDICAID