Healthcare Provider Details

I. General information

NPI: 1932367950
Provider Name (Legal Business Name): PATRICIA V GILLAY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W RUSSELL ST SUITE 210
SALINE MI
48176-1160
US

IV. Provider business mailing address

420 W RUSSELL ST SUITE 210
SALINE MI
48176-1160
US

V. Phone/Fax

Practice location:
  • Phone: 734-944-0322
  • Fax:
Mailing address:
  • Phone: 734-944-0322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number089030
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: