Individual
ROBERT KENNETH GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1515 VILLAGE DR, COTTAGE GROVE, OR 97424-9700
(541) 813-4320
Mailing address
1515 VILLAGE DR, COTTAGE GROVE, OR 97424-9700
(541) 813-4320
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10042860
OR
390200000X
Student in an Organized Health Care Education/Training Program
201806637
OR
Other
Enumeration date
01/10/2025
Last updated
04/07/2025
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