Individual
MADELINE MCCLEARY GILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
215 HIGHLAND DR, PORTLAND, TN 37148-4502
(615) 325-9263
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
32707
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
N/A
—
Enumeration date
01/25/2023
Last updated
01/25/2023
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