Provider Demographics
NPI:1437869245
Name:CROSS, GILLIANNE AIMEE' (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:GILLIANNE
Middle Name:AIMEE'
Last Name:CROSS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 S CONROE MEDICAL DR STE 110
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-5395
Mailing Address - Country:US
Mailing Address - Phone:936-760-9900
Mailing Address - Fax:936-760-9926
Practice Address - Street 1:603 S CONROE MEDICAL DR STE 110
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-5395
Practice Address - Country:US
Practice Address - Phone:936-760-9900
Practice Address - Fax:936-760-9926
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1099915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily