Individual
KIMBERLY LEE GILLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2347 ROSSVILLE BLVD, CHATTANOOGA, TN 37408-2250
(423) 265-3122
Mailing address
2347 ROSSVILLE BLVD, CHATTANOOGA, TN 37408-2250
(423) 265-3122
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
67820
TN
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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