Individual
MS. TABITHA SARA GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4400 BROADWAY BLVD STE 206, KANSAS CITY, MO 64111-3342
(816) 561-8100
(816) 561-8154
Mailing address
17888 SUNSET DR, WESTON, MO 64098-1000
(816) 344-9611
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025010733
MO
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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