Provider Demographics
NPI:1215458054
Name:GILLIOM, ALDEN JANE (APRN)
Entity type:Individual
Prefix:
First Name:ALDEN
Middle Name:JANE
Last Name:GILLIOM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-688-7040
Mailing Address - Fax:614-293-0067
Practice Address - Street 1:1145 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3117
Practice Address - Country:US
Practice Address - Phone:614-688-7040
Practice Address - Fax:614-293-0067
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHLE-00020270363LW0102X
OHAPRN.CNP.021478363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health