Individual
MICHELLE LEE GILLILAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
644 LIONS CLUB RD, TOLLESBORO, KY 41189-8704
(606) 202-1714
Mailing address
644 LIONS CLUB RD, TOLLESBORO, KY 41189-8704
(606) 202-1714
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1124221
KY
363LF0000X
Family Nurse Practitioner
Primary
3018334
KY
Other
Enumeration date
10/29/2021
Last updated
07/28/2023
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