Allie Gillis
Individual provider Active NPI Registered Nurse · Lyons, GA
NPI 1508787128 · NPPES record last updated Jul 21, 2026
Key facts
- NPI
- 1508787128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN299497 (GA)
- Practice address
- 714 NW Broad St
Lyons, GA 30436-5648 - Phone
- (912) 526-8109
- NPI assigned
- Jul 21, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN299497 | GA | Yes |
Addresses
Primary practice location
714 NW Broad St
Lyons, GA 30436-5648
Mailing address
714 NW Broad St
Lyons, GA 30436-5648
Phone (912) 526-8109
Other providers in Lyons, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2026. 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.