Provider Demographics
NPI:1063220242
Name:GILBRIDE, REBECCA CORINNE (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CORINNE
Last Name:GILBRIDE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:CORINNE
Other - Last Name:GILBRIDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REBECCA GILBRIDE
Mailing Address - Street 1:4678 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-9744
Mailing Address - Country:US
Mailing Address - Phone:707-205-7913
Mailing Address - Fax:
Practice Address - Street 1:2200 TYDD STREET EUREKA, CA 95501
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501
Practice Address - Country:US
Practice Address - Phone:707-205-7913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95292065163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health