Individual
STEPHANIE RAE GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, NP-C, CRNP
Contact information
Practice address
3300 CENTENNIAL LN, ELLICOTT CITY, MD 21042-3600
(866) 389-2727
Mailing address
3159 PINE ORCHARD LN APT 302, ELLICOTT CITY, MD 21042-4223
(443) 420-8391
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R169531
MD
Other
Enumeration date
09/29/2011
Last updated
02/01/2022
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