Individual
DEVON GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-2416
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-2416
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP161068
ME
Other
Enumeration date
08/04/2016
Last updated
11/30/2020
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