Mr. Blake Hamilton Gilliam
Nurse Practitioner Nurse Practitioner - Acute Care Nurse Practitioner - Gerontology
1230 Slaughter Rd Ste C
Madison
, Alabama 35758-5901
Mr. Blake Hamilton Gilliam
Nurse Practitioner Nurse Practitioner - Acute Care Nurse Practitioner - Gerontology
1230 Slaughter Rd Ste C
Madison
, Alabama 35758-5901
(256) 325-0955
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About
Features
Specialties
- Nurse Practitioner
- Nurse Practitioner - Acute Care
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Mr. Blake Hamilton Gilliam
- 1230 Slaughter Rd Ste C
- Madison, AL
- Zip : 35758-5901
- Phone : (256) 325-0955
Second Address
- Mr. Blake Hamilton Gilliam
- 1230 Slaughter Rd Ste C
- Madison, AL
- Zip : 35758-5901
- Phone : (256) 325-0955
Reviews
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Is Mr. Blake Hamilton Gilliam a sole practitioner?
Is Mr. Blake Hamilton Gilliam accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1-153719 | AL |
| N | 363LA2100X | Nurse Practitioner - Acute Care | 1-153719 | AL |
| N | 363LG0600X | Nurse Practitioner - Gerontology | 1-153719 | AL |
National Provider Identifier
| NPI | 1043845787 |
|---|---|
| Provider Name | Mr. Blake Hamilton Gilliam |
| First Address | Madison, AL 35758-5901 |
| Second Address | Madison, AL 35758-5901 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/03/2020 |
| Last Update Date | 03/03/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.