Provider Demographics
NPI:1144681420
Name:GIL, ANDRES FERNANDO (NP-C)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:FERNANDO
Last Name:GIL
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10185 S ALESSI PEAK PL
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-0029
Mailing Address - Country:US
Mailing Address - Phone:520-904-7062
Mailing Address - Fax:
Practice Address - Street 1:515 W GRANGEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-2861
Practice Address - Country:US
Practice Address - Phone:844-623-0999
Practice Address - Fax:844-306-5999
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ228503363LF0000X
TXAP130270363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ601728Medicaid
TX356882601Medicaid