Individual
CHASTITY GILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
2014044014
Contact information
Practice address
805 N ORANGE ST, BUTLER, MO 64730-9382
(660) 679-4636
(660) 679-4310
Mailing address
155550S 2519 RD, WALKER, MO 64790
(417) 684-5784
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2014044014
MO
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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