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Individual
BRENNA GILLIS
Active
Individual
BRENNA GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
203108
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
20578
TN
Other
Enumeration date
09/24/2015
Last updated
10/08/2015
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