Clinton Terry Gillespie, RN
Individual provider Active NPI Medical-Surgical Registered Nurse · Millcreek, UT
NPI 1376360784 · NPPES record last updated Sep 25, 2024
Key facts
- NPI
- 1376360784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical-Surgical Registered Nurse 163WM0705X
- License
- 14153666-3102 (UT)
- Practice address
- 1200 E 3900 S
Millcreek, UT 84124-1300 - Phone
- (801) 268-7111
- NPI assigned
- Sep 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14153666-3102 | UT | MD | Medical-Surgical Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 14153666-3102 | UT | Yes |
Addresses
Primary practice location
1200 E 3900 S
Millcreek, UT 84124-1300
Mailing address
1119 W 2500 S
Syracuse, UT 84075-8622
Phone (424) 242-4713
Other providers in Millcreek, UT
- Gary Wayne Foss
- Weston Fredman
- Friends of Switchpoint Inc.
- Yanni B Gallagher
- Alyssa L Gardner
- David Goldsberry
- Abigail Elizabeth Goodridge
- Antonette Patrice Gray
- Annabella Cinderella Greenhalgh
- Richard B Gremillion
All providers in Millcreek, UT · Medical-Surgical Registered Nurse in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.