Individual
MS. STEPHANIE MODENA GILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1221 LEE STREET, CHARLOTTESVILLE, VA 22908-2554
(434) 924-2706
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0024176336
VA
Other
Enumeration date
08/07/2018
Last updated
08/09/2023
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