Individual
LATASHA NICOLE GILLIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
7171 NAILS RD, NICHOLLS, GA 31554-4613
(912) 381-4675
Mailing address
7171 NAILS RD, NICHOLLS, GA 31554-4613
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NCO-000003
GA
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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