ANDREA GILLIAM NP NPI 1720797475

NPI Information

NPI: 1720797475
Provider Name: ANDREA GILLIAM, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4300 MAIN ST
JASPER, TN
ZIP 37347
Phone: (423) 651-1696
Get Directions

Andrea Gilliam, NP is a family nurse practitioner in Jasper, TN with 2 years of experience. Andrea Gilliam, NP NPI is 1720797475. 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:

4300 MAIN ST
JASPER, TN
ZIP 37347-438
Phone: (423) 651-1696
Fax: (423) 651-1697

The NPI 1720797475 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 11/22/2022 and was last updated on 11/22/2022.

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	363LF0000X	Nurse Practitioner	Family	32804	TENNESSEE	Yes

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: 5/5/2024

NPI Synchronization or Removal

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