Provider Demographics
NPI:1780811018
Name:GILGER, KELLEY ANN (BSN, CNM)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:ANN
Last Name:GILGER
Suffix:
Gender:F
Credentials:BSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ROUTE 72 W STE 305
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2475
Mailing Address - Country:US
Mailing Address - Phone:609-978-3359
Mailing Address - Fax:609-978-3060
Practice Address - Street 1:1100 ROUTE 72 W STE 305
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2475
Practice Address - Country:US
Practice Address - Phone:609-978-3359
Practice Address - Fax:609-978-3060
Is Sole Proprietor?:No
Enumeration Date:2009-06-13
Last Update Date:2009-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00036401176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife