Individual
CRYSTAL GILLIS
Active
Individual
CRYSTAL GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
170713
NC
363LF0000X
Family Nurse Practitioner
Primary
5012411
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170713
NORTH CAROLINA BOARD OF NURSING
NC
01
—
5012411
FAMILY NURSE PRACTITIONER
NC
Enumeration date
12/15/2008
Last updated
08/14/2025
Update your record
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