Individual
MRS. MALINDA ELIZABETH ELLIS GILMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CEO
Contact information
Practice address
32 UNDERWOOD ST, SEBASTOPOL, MS 39359
(601) 625-7840
(601) 625-7848
Mailing address
PO BOX 102, 32 UNDERWOOD ST, SEBASTOPOL, MS 39359
(601) 625-7840
(601) 625-7848
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R799883
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070221
BCBS OF MS
MS
05
—
7976082
—
MS
Enumeration date
11/07/2006
Last updated
07/08/2007
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