Individual provider · Type 1 NPI
Carolyn Ann Gilley
Primary Care Clinic/Center · Random Lake, WI
NPI number
1043749617
Active
Practice location
220 Carroll St
Random Lake, WI 53075-1795
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
About NPI 1043749617
Carolyn Ann Gilley's National Provider Identifier is 1043749617, issued on Jun 7, 2017. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Random Lake, WI. The record was last updated on Jun 7, 2017.