Provider Demographics
NPI:1912786013
Name:GILLESPIE, ANNITA FIELDS
Entity Type:Individual
Prefix:
First Name:ANNITA
Middle Name:FIELDS
Last Name:GILLESPIE
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 1:321 AG DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-9063
Mailing Address - Country:US
Mailing Address - Phone:919-452-8129
Mailing Address - Fax:
Practice Address - Street 1:321 AG DR
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596-9063
Practice Address - Country:US
Practice Address - Phone:919-452-8129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator