Individual
MRS. TRACIE LANE GILLILAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
360 MC 7097, FLIPPIN, AR 72634-8419
(870) 404-2347
Mailing address
360 MC 7097, FLIPPIN, AR 72634-8419
(870) 404-2347
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
124431
AR
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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