Provider Demographics
NPI:1699059345
Name:LAWRENCE-GILBERT, VICTORIA ANNE (APRN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANNE
Last Name:LAWRENCE-GILBERT
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:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-0550
Mailing Address - Country:US
Mailing Address - Phone:606-796-3029
Mailing Address - Fax:606-796-6221
Practice Address - Street 1:211 KY 59
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179-7647
Practice Address - Country:US
Practice Address - Phone:606-796-3029
Practice Address - Fax:844-474-7624
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007446364SA2200X, 363LF0000X
MO2017040275364SA2200X
OH13390364SA2200X
MO2017041037363LF0000X
IN71003734A363LF0000X, 364S00000X
OH021552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201076160Medicaid
LA7100254880Medicaid
KY50052936OtherPASSPORT - NCMA
KY000000834281OtherANTHEM - NCMA
KY151608OtherSIHO - NCMA
LA7100254880Medicaid