Provider Demographics
NPI:1609679141
Name:GILMAN, SAMANTHA DAWN (MSN, APRN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DAWN
Last Name:GILMAN
Suffix:
Gender:
Credentials:MSN, APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4666 STATE HIGHWAY 1056
Mailing Address - Street 2:
Mailing Address - City:RANSOM
Mailing Address - State:KY
Mailing Address - Zip Code:41558-8423
Mailing Address - Country:US
Mailing Address - Phone:859-270-2476
Mailing Address - Fax:
Practice Address - Street 1:4666 STATE HIGHWAY 1056
Practice Address - Street 2:
Practice Address - City:RANSOM
Practice Address - State:KY
Practice Address - Zip Code:41558-8423
Practice Address - Country:US
Practice Address - Phone:859-270-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4034515363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health