Provider Demographics
NPI:1518639624
Name:GILLIT, BROOKLYN (FNP-C)
Entity type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:
Last Name:GILLIT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 ANTILLEY RD STE 270
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5247
Mailing Address - Country:US
Mailing Address - Phone:325-428-4790
Mailing Address - Fax:
Practice Address - Street 1:1680 ANTILLEY RD STE 270
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5247
Practice Address - Country:US
Practice Address - Phone:325-428-4790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF09201229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily