Blake Hamilton Gilliam

Nurse Practitioner · Madison, AL

Individual Active NPI

NPI number 1043845787

Practice location

1230 Slaughter Rd Ste C
Madison, AL 35758-5901
Phone
(256) 325-0955

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NPI record

NPI
1043845787
Entity type
Individual (Type 1)
Enumeration date
March 3, 2020
Last updated
March 3, 2020
Certified
March 3, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nurse Practitioner Primary 363L00000X 1-153719 AL
Gerontology Nurse Practitioner 363LG0600X 1-153719 AL
Acute Care Nurse Practitioner 363LA2100X 1-153719 AL

About Blake Gilliam

Blake Hamilton Gilliam is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 1230 Slaughter Rd Ste C, Madison, AL 35758-5901. The NPI number 1043845787 was assigned on March 3, 2020 and the record was last updated on March 3, 2020.

Blake Gilliam lists 3 licenses in the registry: #1-153719 (AL) for Nurse Practitioner; #1-153719 (AL) for Gerontology Nurse Practitioner; #1-153719 (AL) for Acute Care Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Blake Hamilton Gilliam?

The NPI number is 1043845787.

What is the phone number of Blake Gilliam?

The phone number listed for the practice location is (256) 325-0955.

Where is Blake Gilliam located?

1230 Slaughter Rd Ste C, Madison, AL 35758-5901.

What is the taxonomy code for Blake Gilliam?

The primary taxonomy code is 363L00000X – Nurse Practitioner; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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