Jaclyn P Gilliam, CNM | |
1761 W Loop 281, Longview, TX 75604-2734 | |
(903) 758-2610 | |
(903) 758-7081 |
Full Name | Jaclyn P Gilliam |
---|---|
Gender | Female |
Speciality | Advanced Practice Midwife |
Location | 1761 W Loop 281, Longview, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154483113 | NPI | - | NPPES |
124101006 | Medicaid | TX | |
124101005 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367A00000X | Advanced Practice Midwife | AP109416 (Texas) | Primary |
Entity Name | Longview Wellness Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942269493 PECOS PAC ID: 1254367766 Enrollment ID: O20050714001046 |
Mailing Address | Practice Location Address |
---|---|
Jaclyn P Gilliam, CNM 1107 E Marshall Ave, Longview, TX 75601-5602 Ph: (903) 675-8261 | Jaclyn P Gilliam, CNM 1761 W Loop 281, Longview, TX 75604-2734 Ph: (903) 758-2610 |
Mary Beth Smith, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 705 E Marshall Ave, Suite 3000, Longview, TX 75601 Phone: 903-315-2700 Fax: 903-236-2575 | |
Gabrielle Misenheimer, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 705 E Marshall Ave Ste 3000, Longview, TX 75601 Phone: 903-758-2610 Fax: 903-758-7081 | |
Kelly Denise Royce, Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 323 E Hawkins Pkwy Fl 2, Longview, TX 75605 Phone: 903-315-5733 | |
Jacqueline Weber, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 705 E Marshall Ave Ste 3000, Longview, TX 75601 Phone: 903-758-2610 Fax: 903-758-7081 | |
Sylyna G Kennedy, RN, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 705 E Marshall Ave Ste 3000, Longview, TX 75601 Phone: 903-758-2610 Fax: 903-587-7081 |