Individual
AMY MICHELE GILLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
191 KINSEY RD, XENIA, OH 45385-1538
(937) 944-3773
Mailing address
191 KINSEY RD, XENIA, OH 45385-1538
(937) 944-3773
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.140666.MEDS-IV
OH
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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