Provider Demographics
NPI:1275369373
Name:GAILMARD, KIMBERLY ANNE (APRN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:GAILMARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10720 ETZLER MILL RD
Mailing Address - Street 2:
Mailing Address - City:WOODSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21798-8006
Mailing Address - Country:US
Mailing Address - Phone:443-864-9685
Mailing Address - Fax:
Practice Address - Street 1:12931 OAK HILL AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2914
Practice Address - Country:US
Practice Address - Phone:301-797-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR196339363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner