Individual
MARY GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
110 PORTER DRIVE, MIDDLEBURY, VT 05753
(802) 388-7959
(802) 388-8136
Mailing address
104 PORTER DR, MIDDLEBURY, VT 05753-8527
(802) 388-8808
(802) 388-8322
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1010018668
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011539
—
VT
Enumeration date
12/27/2005
Last updated
09/16/2008
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