Individual
MARY KATHERINE SMITH GILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
309 JACKSON STREET, EMERGENCY DEPARTMENT, MONROE, LA 71201
(318) 966-4171
(318) 966-4856
Mailing address
309 JACKSON ST, MONROE, LA 71201-7407
(318) 966-4171
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1060119
LA
363A00000X
Physician Assistant
Primary
PA.A10588
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2146416
—
LA
Enumeration date
05/23/2007
Last updated
05/13/2026
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