| Crystal Gillis, FNP | |
|
403 Fairview St, Clinton, NC 28328-2399 | |
| (910) 592-6011 | |
| (910) 592-0819 |
| Full Name | Crystal Gillis |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 403 Fairview St, Clinton, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548405962 | NPI | - | NPPES |
| 5012411 | Other | NC | FAMILY NURSE PRACTITIONER |
| 170713 | Other | NC | NORTH CAROLINA BOARD OF NURSING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WH1000X | Registered Nurse - Hospice | 170713 (North Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 5012411 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Liberty Home Care | Dunn, NC | Home health agency |
| Kindred At Home | Pink hill, NC | Home health agency |
| Sampson Regional Medical Center | Clinton, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Clinton Medical Clinic, Inc. | 6406821628 | 14 |
| Entity Name | Clinton Medical Clinic, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780629154 PECOS PAC ID: 6406821628 Enrollment ID: O20040831001347 |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Gillis, FNP 6417 Allie Cooper Rd, Godwin, NC 28344-8379 Ph: (910) 592-6011 | Crystal Gillis, FNP 403 Fairview St, Clinton, NC 28328-2399 Ph: (910) 592-6011 |
Hayley Brott, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 403 Fairview St, Clinton, NC 28328 Phone: 910-590-6011 | |
Jeffrey Wayne Autry, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1004 Beamon St., Clinton, NC 28328 Phone: 910-592-9113 Fax: 910-590-0050 | |
Sharry Jackson Malpass, DNP, NP-C, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 403 Fairview St, Clinton, NC 28328 Phone: 910-592-6011 Fax: 910-592-0811 | |
Jill Anne Breton, CNM, WHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 360 County Complex Rd Ste 200, Clinton, NC 28328 Phone: 910-592-1131 Fax: 910-592-4724 | |
Jamie Alysse Weiner, DNP, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 403 Fairview St, Clinton, NC 28328 Phone: 910-592-6011 | |
Mrs. Lauren Elaine Aves, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 403 Fairview St, Clinton, NC 28328 Phone: 910-592-6011 Fax: 910-592-0811 | |
Mrs. Tara Lynn Marr-carter, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 403 Fairview St, Clinton, NC 28328 Phone: 910-592-6011 Fax: 910-592-0811 |