Individual
BATAVIA ANTONETTE GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14765 GALLANT LN, WALDORF, MD 20601-5516
(240) 784-0506
Mailing address
14765 GALLANT LN, WALDORF, MD 20601-5516
(240) 784-0506
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R167761
MD
Other
Enumeration date
11/30/2020
Last updated
12/26/2020
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