Individual
ELIZABETH BOYLE GILLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6000
Mailing address
5522 DELOR ST, SAINT LOUIS, MO 63109-2803
(636) 399-5338
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017029167
MO
Other
Enumeration date
09/29/2017
Last updated
03/27/2019
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