Individual
MS. PATRICIA L. GILLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1301 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2122
(817) 882-3680
(817) 878-5135
Mailing address
4245 OAK PARK CT, FORT WORTH, TX 76109-9552
(817) 923-3366
(972) 386-4292
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
221908
TX
Other
Enumeration date
12/29/2005
Last updated
07/09/2007
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