Individual
MARY KATHERINE GILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
35 RAY E TALLEY CT, SIMPSONVILLE, SC 29680-6772
(864) 967-7028
(864) 228-0915
Mailing address
10 DACUS DR, GREENVILLE, SC 29605-6008
(864) 277-7005
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
51001
SC
363LF0000X
Family Nurse Practitioner
Primary
APN.4297 APRN
SC
Other
Enumeration date
07/20/2010
Last updated
10/22/2018
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