Individual
ALLISON MARIA GAGNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
77 BATES ST, SUITE 103, LEWISTON, ME 04240-7637
(207) 777-4460
(207) 777-4466
Mailing address
77 BATES ST, SUITE 103, LEWISTON, ME 04240-7637
(207) 777-4460
(207) 777-4466
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA001251
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010211551
EMPLOYED BY HOSPITAL
ME
Enumeration date
01/05/2011
Last updated
01/05/2011
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