Provider Demographics
NPI:1851023782
Name:GILLIM, EMMA (FNP)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:GILLIM
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1102 TRIPLETT ST STE 2100
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-3156
Mailing Address - Country:US
Mailing Address - Phone:270-238-6468
Mailing Address - Fax:270-702-7184
Practice Address - Street 1:1102 TRIPLETT ST STE 2100
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3156
Practice Address - Country:US
Practice Address - Phone:270-238-6468
Practice Address - Fax:270-702-7184
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3017978363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care