Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Latrice Marie Gillis, PMHNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1891407185

Mrs. Latrice Marie Gillis, PMHNP is a Nurse Practitioner in Tonawanda, New York. Qualified in 2022, 4 years ago. Offers telehealth. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

72 Evergreen Dr
Tonawanda, NY 14150-6402
Phone: (716) 799-2063
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 404533 (NY)

Record details

NPI number1891407185
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP
Sole proprietorNo
NPI enumeratedDecember 19, 2022
Last updated in NPPESDecember 19, 2022
Certification dateDecember 19, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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