Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CAROLYN ANN GILLEY
Active Sole ProprietorCAROLYN ANN GILLEY is a Primary Care Clinic healthcare provider located in RANDOM LAKE, Wisconsin. NPI 1043749617 is currently active in the NPPES registry. Verify at CMS.
Primary Care Clinic · RANDOM LAKE, WI
Registration Details
- NPI Number
- 1043749617
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 7, 2017 (9.1973279581122 yrs)
- Last Updated
- Jun 7, 2017
- Sole Proprietor
- Yes
Practice Information
- Address
-
220 CARROLL STRANDOM LAKE, WI, 530751795Browse WI providers · Browse ZIP 53075
- Phone
- 8004903146
- Primary Specialty
-
Primary Care Clinic
261QP2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.