Individual
TIERRA GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
814 DARTMOUTH RD APT B, BALTIMORE, MD 21212-3124
(410) 572-7801
Mailing address
814 DARTMOUTH RD APT B, BALTIMORE, MD 21212-3124
(410) 572-7801
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
A00126215
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
861607291
AGENCY
MD
Enumeration date
04/29/2021
Last updated
04/29/2021
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