Provider Demographics
NPI:1679192967
Name:GILLILAND, SARAH L (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:GILLILAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13595 S SPOON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-9070
Mailing Address - Country:US
Mailing Address - Phone:816-591-6400
Mailing Address - Fax:
Practice Address - Street 1:OLATHE SCHOOL DISTRICT, CENTRAL ELEMENTARY
Practice Address - Street 2:305 E. CEDAR ST.
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061
Practice Address - Country:US
Practice Address - Phone:916-780-7376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-121636-051163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse