Individual
MARY S GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
1301 W 6TH AVE STE 207, STILLWATER, OK 74074-4381
(405) 533-3010
(405) 533-3013
Mailing address
1919 S WHEELING STE 500, TULSA, OK 74104
(918) 748-7650
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R0030806
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R0030806
STATE LIC.
OK
Enumeration date
01/29/2009
Last updated
12/30/2015
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