Individual
RANDI GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4213 ALBERTVILLE WAY, ANTELOPE, CA 95843-5274
(916) 806-0659
Mailing address
4213 ALBERTVILLE WAY, ANTELOPE, CA 95843-5274
(916) 806-0659
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
591975
CA
163WD0400X
Diabetes Educator Registered Nurse
591975
CA
163WW0000X
Wound Care Registered Nurse
Primary
591975
CA
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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