Gilliam, Martha Jane

Gilliam, Martha Jane is an individual health care provider with primary practice located at 5301 E Grant Rd , Tucson AZ 85712-2805. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Gilliam, Martha Jane can be contacted via phone (520) 324-3771.

Contact Information

Primary practice address
5301 E Grant Rd Tucson AZ 85712-2805
Phone: (520) 324-3771
Fax: (520) 324-8091
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN053744 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP0273 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN053744 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP7115 Arizona

Profile Details

NPI number 1578549333
LBN Legal business name Gilliam, Martha Jane
Credentials ANP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Sep 16th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578549333 NPPES
Arizona MEDICAID 574576

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