Provider Demographics
NPI:1386838936
Name:GILLEYLEN, BARBARA ANN (APRN-ANP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANN
Last Name:GILLEYLEN
Suffix:
Gender:F
Credentials:APRN-ANP
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 MEDICAL PARK
Mailing Address - Street 2:SUITE 501
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-8903
Mailing Address - Country:US
Mailing Address - Phone:803-540-1000
Mailing Address - Fax:803-540-1011
Practice Address - Street 1:2 MEDICAL PARK
Practice Address - Street 2:SUITE 501
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8903
Practice Address - Country:US
Practice Address - Phone:803-540-1000
Practice Address - Fax:803-540-1011
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN 2927363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC97175OtherRN LICENSE
SCNP1377Medicaid
SC2927OtherAPRN
SCAA35352603Medicare UPIN