Individual
MRS. MELISSA DE ANN GILLISPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
512 S PRAIRIE AVE, PUEBLO, CO 81005-1724
(719) 542-3218
Mailing address
512 S PRAIRIE AVE, PUEBLO, CO 81005-1724
(719) 542-3218
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
109079
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07090798
—
CO
Enumeration date
01/24/2007
Last updated
08/14/2007
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