Provider Demographics
NPI:1891393856
Name:GILBERT, GLORY S (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:GLORY
Middle Name:S
Last Name:GILBERT
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:GLORY
Other - Middle Name:
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:301 MCCULLOUGH DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3310
Mailing Address - Country:US
Mailing Address - Phone:910-930-8520
Mailing Address - Fax:
Practice Address - Street 1:301 MCCULLOUGH DR STE 400
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1336
Practice Address - Country:US
Practice Address - Phone:910-930-8520
Practice Address - Fax:984-538-0471
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013677363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health