Provider Demographics
NPI:1174708549
Name:GILL, RITA K (MS, CRNP)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:K
Last Name:GILL
Suffix:
Gender:F
Credentials:MS, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 PLUMAS CT
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-2960
Mailing Address - Country:US
Mailing Address - Phone:530-750-2520
Mailing Address - Fax:530-751-9915
Practice Address - Street 1:1535 PLUMAS CT
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2960
Practice Address - Country:US
Practice Address - Phone:530-750-2520
Practice Address - Fax:530-751-9915
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18516363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health