| Doctor Name: | MRS. NICOLE GILL |
| NPI Number: | 1093865032 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 049613455 |
| Business Practice Address: | 416 Connable Ave Petoskey, MI - 497702212 |
| Business Phone Number: | 2314875000 |
| Business Fax Number: | 2314873063 |
| Mailing Address: | 1014 Sixth St, TRAVERSE CITY |
| State: | MI |
| Postal Code: | 496842381 |
| Phone Number: | 2319229270 |
| Fax Number: | 2319229271 |
| NPI Enumeration Date: | 01/11/2007 |
| NPI Last Update Date: | 08/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 049613455 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |