Provider Demographics
NPI:1679765879
Name:GIELISSE, ANNE B (ARNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:B
Last Name:GIELISSE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2242 PALM HARBOR BLVD
Mailing Address - Street 2:#64
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-2628
Mailing Address - Country:US
Mailing Address - Phone:727-916-0567
Mailing Address - Fax:727-784-7318
Practice Address - Street 1:2242 PALM HARBOR BLVD
Practice Address - Street 2:#64
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-2628
Practice Address - Country:US
Practice Address - Phone:727-916-0567
Practice Address - Fax:727-784-7318
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1725562163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult