Provider Demographics
NPI:1871695957
Name:GILDOW, VIQUI HAYDEE (CRNP RN)
Entity type:Individual
Prefix:
First Name:VIQUI
Middle Name:HAYDEE
Last Name:GILDOW
Suffix:
Gender:F
Credentials:CRNP RN
Other - Prefix:
Other - First Name:VIQUI
Other - Middle Name:MANRING
Other - Last Name:GILDOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP RN
Mailing Address - Street 1:206 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-8244
Mailing Address - Country:US
Mailing Address - Phone:814-466-8775
Mailing Address - Fax:
Practice Address - Street 1:118 RITENOUR BUILDING
Practice Address - Street 2:THE PENNSYLVANIA STATE UNIVERSITY
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802
Practice Address - Country:US
Practice Address - Phone:814-863-8448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN300142L163WG0000X
PASP003148G363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health