MEDICARE: CHRISTINA GILLMAN FNP-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
1	363LF0000X	Family Nurse Practitioner	AP134919	TX

General Provider Information

NPI Number	:	1528571585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA GILLMAN FNP-BC

Provider Business Mailing Address
First Line	:	17515 BIG BASIN LN
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-1560
Country	:	US
Telephone Number	:	832-266-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3014
Country	:	US
Telephone Number	:	713-500-3261
Fax Number	:	713-500-3263

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

Provider Enumeration Date	:	11/13/2017
Last Update Date	:	11/23/2022

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