Individual
MS. VIRGINIA C GILLISPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ND, CNS, ACHPN, CCM
Contact information
Practice address
1619 N. GRAND AVE., STE 402, PUEBLO, CO 81003-2658
(719) 595-7760
(719) 595-7765
Mailing address
PO BOX 560825, DENVER, CO 80256-0825
(719) 595-7580
(719) 545-0176
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
112546
CO
363L00000X
Nurse Practitioner
Primary
991091
CO
364S00000X
Clinical Nurse Specialist
3310
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015038
KAISER-COMMERCIAL NUMBER
—
05
—
98552376
—
CO
Enumeration date
02/27/2007
Last updated
01/29/2018
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