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NPI Code Detail

MEDICARE: ALLISON GILLEY PMHNP-BC

MEDICARE: ALLISON GILLEY PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRN217118GA

General Provider Information

NPI Number : 1124674999
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON GILLEY PMHNP-BC
Provider Business Mailing Address
First Line : 2515 ASHTON DR
Second Line :
City : ROSWELL
State : GA
Zip : 30076-4236
Country : US
Telephone Number : 404-989-2753
Fax Number :
Provider Business Practice Location Address
First Line : 2801 BUFORD HWY NE STE 100
Second Line :
City : BROOKHAVEN
State : GA
Zip : 30329-2146
Country : US
Telephone Number : 678-820-7830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2019
Last Update Date : 08/16/2019

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Directions to “ ALLISON GILLEY PMHNP-BC” Practice Location

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