Provider Demographics
NPI:1861264772
Name:GOREE, GILLIAN (NP)
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:
Last Name:GOREE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 SPRING GARDEN ST APT 3F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3855
Mailing Address - Country:US
Mailing Address - Phone:703-489-0073
Mailing Address - Fax:
Practice Address - Street 1:2401 E EVESHAM RD STE A1
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9590
Practice Address - Country:US
Practice Address - Phone:856-424-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14945000363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health