Individual
TAMMIE RENEE GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1041 EAST SULLIVAN ST, KINGSPORT, TN 37660
(423) 224-1620
(423) 224-1640
Mailing address
1041 EAST SULLIVAN ST, KINGSPORT, TN 37660
(423) 224-1620
(423) 224-1640
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0000112103
TN
Other
Enumeration date
11/19/2007
Last updated
11/30/2007
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