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General NPI Number Information
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NPI Number | 1629358593
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Entity Type | Individual
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Provider Name | DIANE LEE GILLILAND NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/24/2011
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Last Update Date | 04/15/2016
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Provider Practice Location Address
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Address Line | 15840 MEDICAL DR S SUITE B
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City | FINDLAY
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State | OH
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Zip | 45840-7833
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Country | US
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Telephone | 419-425-3780
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Fax |
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Provider Business Mailing Address
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Address Line | 1733 WESTERN AVE STE A
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City | FINDLAY
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State | OH
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Zip | 45840-1347
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Country | US
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Telephone | 419-423-2754
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Fax | 419-423-7357
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | COA.12553-NP
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License Number State | OH
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