Provider Demographics
NPI:1053538728
Name:GILLISPIE, NANCY B (AUD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:B
Last Name:GILLISPIE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:SUMERCO
Mailing Address - State:WV
Mailing Address - Zip Code:25567-9541
Mailing Address - Country:US
Mailing Address - Phone:304-784-2552
Mailing Address - Fax:304-756-3818
Practice Address - Street 1:375 DEER RUN
Practice Address - Street 2:
Practice Address - City:SUMERCO
Practice Address - State:WV
Practice Address - Zip Code:25567-9541
Practice Address - Country:US
Practice Address - Phone:304-784-2552
Practice Address - Fax:304-756-3818
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA0212231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist