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General NPI Number Information
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NPI Number | 1053128892
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Entity Type | Organization
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Legal Business Name | KERSTIN GILLESPIE LLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 14875 W STATE HIGHWAY 29
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City | LIBERTY HILL
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State | TX
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Zip | 78642-4294
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Country | US
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Telephone | 512-566-0448
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Fax | 512-566-0449
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Provider Business Mailing Address
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Address Line | 14875 W STATE HIGHWAY 29
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City | LIBERTY HILL
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State | TX
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Zip | 78642-4294
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Country | US
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Telephone | 512-566-0448
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Fax | 512-566-0449
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Authorized Official
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Title or Position | OWNER AUTHORIZED OFFICIAL
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Name | KERSTIN HOLL GILLESPIE
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Credential | DNP, APRN, FNP-BC
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Telephone | 512-566-0448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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