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Individual

MRS. MARTHA JANE GILLIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP-BC

Contact information

Practice address
5301 E GRANT RD, TUCSON, AZ 85712-2805
(520) 324-3771
(520) 324-8091
Mailing address
PO BOX 31235, TUCSON, AZ 85751-1235
(520) 324-4100

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN053744
AZ
363LA2200X
Adult Health Nurse Practitioner
AP0273
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP7115
AZ
363LA2200X
Adult Health Nurse Practitioner
RN053744
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
574576
AZ
Enumeration date
12/22/2005
Last updated
09/16/2021
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