Most Relevant Information
Provider Data
| NPI Number: | 1003308776 |
| Provider Name: | VICKI JANELLE GILLHAM RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 695658 |
Most Important Dates
| Enumeration Date: | 05/30/2018 |
| Last Updated: | 05/30/2018 |
Provider Practice Location
502 OLD BROCK ROAD #134
WEATHERFORD
TX
76088
Practice Location Phone/Fax
| Phone: | 5126202799 |
| Fax: |
Provider Mailing Location
PO BOX 1481
WEATHERFORD
TX
760861481
Provider Mailing Phone/Fax
| Phone: | 5126202799 |
| Fax: |