Provider Demographics
NPI:1851724082
Name:GILLEY, KAILEY NICOLE
Entity Type:Individual
Prefix:
First Name:KAILEY
Middle Name:NICOLE
Last Name:GILLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100238
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0238
Mailing Address - Country:US
Mailing Address - Phone:352-294-8278
Mailing Address - Fax:
Practice Address - Street 1:10831 SW 67TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-9345
Practice Address - Country:US
Practice Address - Phone:352-873-3800
Practice Address - Fax:352-873-4800
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9294207363L00000X
FLARNP9294207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner