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Individual

EMILY LYNN GILLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1320 W LOMBARD ST, DAVENPORT, IA 52804-2029
(563) 333-5827
Mailing address
1320 W LOMBARD ST, DAVENPORT, IA 52804-2029
(563) 333-5827

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8267-23
WI
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1538859897
WI
Enumeration date
05/10/2023
Last updated
05/13/2025
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