Individual
MRS. MELANIE GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
120 DESERT SAGE WAY, MOUNTAIN HOME, ID 83647-1038
(208) 587-3988
(208) 587-3324
Mailing address
120 DESERT SAGE WAY, MOUNTAIN HOME, ID 83647-1038
(208) 696-7203
(208) 587-3324
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19372
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN19372
STATE LICENSE
TN
Enumeration date
11/18/2014
Last updated
06/11/2025
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