Provider Demographics
NPI:1568267359
Name:GILLESPIE, CALLIE ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:ANN
Last Name:GILLESPIE
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 1:28779 NICK DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-7009
Mailing Address - Country:US
Mailing Address - Phone:502-386-2283
Mailing Address - Fax:
Practice Address - Street 1:28779 NICK DAVIS RD
Practice Address - Street 2:
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-7009
Practice Address - Country:US
Practice Address - Phone:256-233-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-186166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily