| NPI | 1518911437 |
|---|---|
| Former Name | MICHELLE ANN GILLIAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP3246) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP3246) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP3246) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2024-02-14 |