Individual
ELIZABETH JAN GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3079 PEACHTREE INDUSTRIAL BLVD, DULUTH, GA 30097-2215
(800) 945-6133
(678) 546-3606
Mailing address
3090 COBBLESTONE DR, PACE, FL 32571-8425
(850) 995-6193
(850) 995-6193
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9208292
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009982125
—
AL
05
—
306793900
—
FL
01
—
59173332
BCBS
AL
01
—
59173333
BCBS
AL
01
—
G3438
BCBS
FL
01
—
P00175638
PALMETTO GBA-RR MEDICARE
—
Enumeration date
05/27/2006
Last updated
12/29/2009
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