MEDICARE: MS. EMILY V GILLESPIE MSN, FNP

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
1	363LF0000X	Family Nurse Practitioner	RN0000042138	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174522007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILY V GILLESPIE MSN, FNP

Provider Business Mailing Address
First Line	:	PO BOX 10005
Second Line	:	ATTN LEE PIERONI
City	:	FLORENCE
State	:	AL
Zip	:	35631-2005
Country	:	US
Telephone Number	:	931-853-6970
Fax Number	:	931-853-6974

Provider Business Practice Location Address
First Line	:	722 N. MILITARY AVE.
Second Line	:
City	:	LORETTO
State	:	TN
Zip	:	38469
Country	:	US
Telephone Number	:	931-853-6970
Fax Number	:	931-853-6974

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/21/2022

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