Provider Demographics
NPI:1194761429
Name:GILLILAND, FRANCES (NP)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:GILLILAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:
Other - Last Name:LEICHHARDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-629-6000
Mailing Address - Fax:502-629-5865
Practice Address - Street 1:231 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1821
Practice Address - Country:US
Practice Address - Phone:502-629-6000
Practice Address - Fax:502-629-5865
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004744363LP0200X, 363LP0222X
FLAPRN9448687363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200894600Medicaid
KY78017456Medicaid
KY0787518Medicare PIN
KY78017456Medicaid
KYP400017935Medicare PIN