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Individual

REBECCA ANN GILLINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
30 CRESCENT AVE, SARATOGA SPRINGS, NY 12866
(518) 584-3600
Mailing address
4 WAYNE CT, QUEENSBURY, NY 12804-9107

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
583553
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402377
NY

Other

Enumeration date
05/16/2018
Last updated
05/31/2018
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