NPI 1134523079

Shadale Gillespie

Practitioner Personal Care Attendant Maricopa, AZ

Practice location

Address: 45565 W. Rainbow Dr., Maricopa, AZ 85139
Phone: (414) 514-9216
Mailing address: 45565 W Rainbow Dr, Maricopa, AZ 85139-6751

Registered specialties

Personal Care Attendant Primary

Nursing Service Related Providers Taxonomy 3747P1801X Licence 5962979 (AZ)

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Registry record

NPI: 1134523079
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Oct 2014
Record last updated: 21 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.