Individual
MRS. KELLEY SUSAN GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
MGH BEACON HILL PRIMARY CARE, 165 CAMBRIDGE ST #501, BOSTON, MA 02114
(617) 726-4900
Mailing address
2300 SOUTHWOOD DR, DARTMOUTH HITCHCOCK - URGENT CARE, NASHUA, NH 03063-1818
(603) 577-4188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA4400
MA
363AM0700X
Medical Physician Assistant
Primary
0525
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30334240
—
NH
Enumeration date
09/25/2006
Last updated
04/23/2024
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