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Individual

CAROL DIANE GILLETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
3818 COUNTY ROAD 36, ANGLETON, TX 77515
(281) 595-2467
(281) 595-2467
Mailing address
PO BOX 1355, ANGLETON, TX 77516
(281) 595-2467
(281) 595-2467

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
507329
TX
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
507329
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
167608204
TX
Enumeration date
03/26/2007
Last updated
10/05/2012
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