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Individual
TAMMY R GILLILAND
Active
Individual
TAMMY R GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN143502
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003159047A
—
GA
05
—
003159047B
—
GA
05
—
003159047C
—
GA
05
—
003159047D
—
GA
01
—
202I503141
MEDICARE PTAN
GA
Enumeration date
10/28/2014
Last updated
07/27/2015
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