Provider Demographics
NPI:1265625974
Name:GILLILAND, SCOTT (RN)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:GILLILAND
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45656-1059
Mailing Address - Country:US
Mailing Address - Phone:740-682-7428
Mailing Address - Fax:
Practice Address - Street 1:215 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:OH
Practice Address - Zip Code:45656-1059
Practice Address - Country:US
Practice Address - Phone:740-682-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-26
Last Update Date:2007-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.322913163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse