Individual
LORETTA M GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10415 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 390-0451
Mailing address
PO BOX 3549, CHATTANOOGA, TN 37404-0549
(423) 698-3309
(423) 624-6355
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10167
TN
367500000X
Certified Registered Nurse Anesthetist
RN114674
TN
367500000X
Certified Registered Nurse Anesthetist
RN135808
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3062499
BCBS
TN
05
—
3625747
—
TN
01
—
K221791
MEDICARE
KY
Enumeration date
02/24/2006
Last updated
02/25/2025
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