Provider Demographics
NPI:1124357454
Name:GILLESPIE, LAUREN G (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:G
Last Name:GILLESPIE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1600 ROCKLAND RD
Mailing Address - Street 2:DIV. OF EMERGENCY MEDICINE
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3607
Mailing Address - Country:US
Mailing Address - Phone:302-651-4296
Mailing Address - Fax:302-651-4227
Practice Address - Street 1:1600 ROCKLAND RD
Practice Address - Street 2:DIV. OF EMERGENCY MEDICINE
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-4296
Practice Address - Fax:302-651-4227
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC50000695363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant