Individual
MS. CANISHA SHANARA GILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1201 1ST ST S, WINTER HAVEN, FL 33880-3904
(863) 294-7062
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 532-0002
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9328108
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
GAA-NP000536
GA
Other
Enumeration date
11/22/2018
Last updated
03/23/2026
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