Provider Demographics
NPI:1043327745
Name:GILMER, JULIA ANN (RD)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ANN
Last Name:GILMER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 WILSON HILL DR
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4432
Mailing Address - Country:US
Mailing Address - Phone:636-937-4052
Mailing Address - Fax:
Practice Address - Street 1:1 JEFFERSON BARRACKS RD.
Practice Address - Street 2:120/JB
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4199
Practice Address - Country:US
Practice Address - Phone:314-894-6632
Practice Address - Fax:314-845-5023
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004029981133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered