Individual
KATRINA MARIE GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1616 W MAIN ST, LEBANON, TN 37087-3100
(615) 449-0990
(615) 449-0970
Mailing address
1616 W MAIN ST, LEBANON, TN 37087-3100
(615) 449-0990
(615) 449-0970
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
927
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3632835
—
TN
Enumeration date
08/10/2005
Last updated
09/13/2007
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