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Individual
KEITH ALAN GILLIS
Active
Individual
KEITH ALAN GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN9322325
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN9322325
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016983200
—
FL
Enumeration date
03/17/2016
Last updated
04/01/2021
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