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Individual
MRS. LISA ANN GILMORE
Active
Individual
MRS. LISA ANN GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-75955
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102644
GRP PTAN
KS
01
—
102644005
IND PTAN
KS
01
—
1205272259
IND NPI
KS
01
—
1891730339
GRP NPI
KS
05
—
30004237450001
—
KS
Enumeration date
05/17/2013
Last updated
10/28/2024
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