Doctor Name: | DEBRA GAIL GILL |
NPI Number: | 1033571054 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RNC, MSN, WHNP |
License Number: | R866022 |
Business Practice Address: | 4892 Briarton Dr Southaven, MS - 386729571 |
Business Phone Number: | 9012620332 |
Business Fax Number: | |
Mailing Address: | 4892 Briarton Dr, SOUTHAVEN |
State: | MS |
Postal Code: | 386729571 |
Phone Number: | 9012620332 |
Fax Number: | |
NPI Enumeration Date: | 03/29/2016 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | R866022 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |