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Individual

GILLIAN MALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 724-5110
Mailing address
15 PROSPECT ST, SOUTH EASTON, MA 02375-1540
(508) 269-3571

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN2324990
MA
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
RN2324990
MA
207RC0000X
Cardiovascular Disease Physician
RN2324990
MA
363L00000X
Nurse Practitioner
Primary
RN2324990
MA

Other

Enumeration date
10/26/2023
Last updated
12/19/2023
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