Individual provider · NPI-1

Quintina Gilmore

Home Health Aide · Jonesboro, GA

NPI number1316558141
StatusActive
Last updated in NPPESAug 14, 2020

Details

NPI
1316558141
Entity type
Individual (NPI-1)
Name
Quintina Gilmore
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 14, 2020
Certification date
Aug 14, 2020
Last updated
Aug 14, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374U00000X Home Health AidePHCP010719GAYes

Practice location

2289 Joplin St
Jonesboro, GA 30236-6775

Phone 706-466-2302

Mailing address

954 S Main St Ne Ste 130b
Conyers, GA 30012-4591

Phone 770-679-0364

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