| NPI | 1770330599 |
|---|---|
| Former Name | DOMINIQUE ALICIA GILLESPIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11032913) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9587343) |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2025-11-17 |