Provider Demographics
NPI:1174522007
Name:GILLESPIE, EMILY V (MSN, FNP)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:V
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10005
Mailing Address - Street 2:ATTN LEE PIERONI
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-2005
Mailing Address - Country:US
Mailing Address - Phone:931-853-6970
Mailing Address - Fax:931-853-6974
Practice Address - Street 1:722 N. MILITARY AVE.
Practice Address - Street 2:
Practice Address - City:LORETTO
Practice Address - State:TN
Practice Address - Zip Code:38469
Practice Address - Country:US
Practice Address - Phone:931-853-6970
Practice Address - Fax:931-853-6974
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000042138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3902121Medicaid
TNQ006421Medicaid
TNS75850Medicare UPIN
TNS75850Medicare UPIN