# CASSANDRA SHEA GILLIAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1639652829
- **Gender:** F
- **Credential:** PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 14205407-4405 | UT | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 53-84213-062 | KS | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP61651272 | WA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | APRN11037013 | FL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | RN171251 | GA | Yes |

## Other

- **Enumeration date:** 09/13/2018
- **Last updated:** 12/09/2025