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Individual
MRS. MARTHA JANE GILLIAM
Active
Individual
MRS. MARTHA JANE GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN053744
AZ
363LA2200X
Adult Health Nurse Practitioner
AP0273
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP7115
AZ
363LA2200X
Adult Health Nurse Practitioner
RN053744
AZ
Other
Enumeration date
12/22/2005
Last updated
09/16/2021
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