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Individual

DENISE A GILHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP.

Contact information

Practice address
11123 PARKVIEW PLAZA DR STE 200, FORT WAYNE, IN 46845-1707
(260) 425-6100
(260) 425-6105
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003721A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000733696
ANTHEM
IN
05
201036060
IN
Enumeration date
09/26/2011
Last updated
10/20/2022
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