Individual
MR. JEDEDIAH A GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
809 LAMONT ST, JOHNSON CITY, TN 37604-5453
(423) 926-1171
(423) 979-3685
Mailing address
809 LAMONT ST, JOHNSON CITY, TN 37604-5453
(423) 926-1171
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
29204
TN
Other
Enumeration date
04/29/2021
Last updated
06/10/2026
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