CRYSTAL GILLIS FNP NPI 1548405962

NPI Information

NPI: 1548405962
Provider Name: CRYSTAL GILLIS, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: CLINTON MEDICAL CLINIC, INC.

PECOS Registration: Yes

Address:
403 FAIRVIEW ST
CLINTON, NC
ZIP 28328
Phone: (910) 592-6011
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Crystal Gillis, FNP is a family nurse practitioner in Clinton, NC with 5 years of experience. Crystal Gillis, FNP NPI is 1548405962. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

403 FAIRVIEW ST
CLINTON, NC
ZIP 28328-311
Phone: (910) 592-6011

The NPI 1548405962 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/15/2008 and was last updated on 7/23/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WH1000X	Registered Nurse	Hospice	170713	NORTH CAROLINA	No
2	363LF0000X	Nurse Practitioner	Family	5012411	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5012411	OTHER	NORTH CAROLINA	FAMILY NURSE PRACTITIONER
2	170713	OTHER	NORTH CAROLINA	NORTH CAROLINA BOARD OF NURSING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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