| Doctor Name: | NANIS GILMORE |
| NPI Number: | 1003059882 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CDE |
| License Number: | 081001531RN |
| Business Practice Address: | 541 Ne 20th Ave Suite 210 Portland, OR - 972322862 |
| Business Phone Number: | 5032336940 |
| Business Fax Number: | 5032362676 |
| Mailing Address: | 541 Ne 20th Ave, Suite 210 PORTLAND |
| State: | OR |
| Postal Code: | 972322862 |
| Phone Number: | 5032336940 |
| Fax Number: | 5032362676 |
| NPI Enumeration Date: | 04/09/2009 |
| NPI Last Update Date: | 04/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 081001531RN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |