Provider Demographics
NPI:1144677352
Name:GILBERT, RAYMOND RAY (RN)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:RAY
Last Name:GILBERT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 RICHARDSON DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3037
Mailing Address - Country:US
Mailing Address - Phone:404-395-1616
Mailing Address - Fax:
Practice Address - Street 1:1801 RICHARDSON DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3037
Practice Address - Country:US
Practice Address - Phone:404-395-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN136368163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse