Provider Demographics
NPI:1811127137
Name:GILBERT, BRENDA L (APN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:L
Last Name:GILBERT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3740 OCOEE PLACE NW
Mailing Address - Street 2:STE 101
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312
Mailing Address - Country:US
Mailing Address - Phone:423-339-7107
Mailing Address - Fax:423-339-6717
Practice Address - Street 1:3740 OCOEE PLACE NW
Practice Address - Street 2:STE 101
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312
Practice Address - Country:US
Practice Address - Phone:423-339-7107
Practice Address - Fax:423-339-6717
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN14265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily