Individual
MRS. GRETTA LYNN GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, ARNP, FNP-C
Contact information
Practice address
1850 W REPUBLIC RD, SPRINGFIELD, MO 65807-5730
(417) 891-4800
(417) 891-4913
Mailing address
1850 W REPUBLIC RD, SPRINGFIELD, MO 65807-5730
(417) 891-4800
(417) 891-4913
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
138082
MO
363LF0000X
Family Nurse Practitioner
Primary
138082
MO
Other
Enumeration date
07/12/2007
Last updated
03/30/2021
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