Individual
AMANDA KATHLEEN GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1600 S 48TH ST, STE 600, LINCOLN, NE 68506-1283
(402) 483-3333
(402) 048-3329
Mailing address
1600 S 48TH ST, STE 600, LINCOLN, NE 68506-1283
(402) 483-3333
(402) 483-3297
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002279
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002279
IA LICENSE
IA
01
—
1652
LICENSE
NE
Enumeration date
04/02/2012
Last updated
05/17/2013
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