Individual
GABRIELLE N NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
242 BRUNSWICK ST, OLD TOWN, ME 04468-1613
(207) 276-1288
(078) 276-6052
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2744
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2024
Last updated
09/05/2024
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