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NPI Code Detail

MEDICARE: STEPHANIE GILLIAM

MEDICARE:   STEPHANIE  GILLIAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideHHA6083DC

General Provider Information

NPI Number : 1306265848
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE GILLIAM
Provider Business Mailing Address
First Line : 4020 HANSON OAKS DR
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20784-2315
Country : US
Telephone Number : 301-377-4947
Fax Number :
Provider Business Practice Location Address
First Line : 4020 HANSON OAKS DR
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20784-2315
Country : US
Telephone Number : 301-377-4947
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2014
Last Update Date : 04/14/2014

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Directions to “ STEPHANIE GILLIAM ” Practice Location

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