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General NPI Number Information
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NPI Number | 1700844529
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Entity Type | Individual
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Provider Name | GERALD JAMES GILLILAND ANP
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 2919 STOUT RD
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City | MENOMONIE
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State | WI
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Zip | 54751-2313
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Country | US
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Telephone | 715-309-4451
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 KENILWORTH AVE
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City | MOUNT PLEASANT
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State | WI
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Zip | 53403-3642
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Country | US
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Telephone | 608-513-0383
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP8055
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 102440-030
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 238333
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License Number State | WI
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