Provider Demographics
NPI:1396506994
Name:GILLIS, ROSA A
Entity type:Individual
Prefix:MISS
First Name:ROSA
Middle Name:A
Last Name:GILLIS
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 1:359 SAXONBURG RD APT B
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16002-3637
Mailing Address - Country:US
Mailing Address - Phone:724-602-6354
Mailing Address - Fax:
Practice Address - Street 1:359 SAXONBURG RD APT B
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16002-3637
Practice Address - Country:US
Practice Address - Phone:724-602-6354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy