Provider Demographics
NPI:1023021698
Name:GILLESPIE, LINDA JOICE (APRN,BC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JOICE
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15230 COUNTY ROAD 614
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MO
Mailing Address - Zip Code:63841-8907
Mailing Address - Country:US
Mailing Address - Phone:573-421-5620
Mailing Address - Fax:808-246-9349
Practice Address - Street 1:3-3367 KUHIO HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1061
Practice Address - Country:US
Practice Address - Phone:808-246-0497
Practice Address - Fax:808-246-9349
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO086383363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily