Provider Demographics
NPI:1992949747
Name:GILCHRIST, JODY (RN)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:GILCHRIST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16710 E RYAN ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8121
Mailing Address - Country:US
Mailing Address - Phone:480-635-2011
Mailing Address - Fax:480-635-2020
Practice Address - Street 1:16710 E RYAN ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8121
Practice Address - Country:US
Practice Address - Phone:480-635-2011
Practice Address - Fax:480-635-2020
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN140531163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse