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Individual

MS. PATRICIA GILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P, M.S., C.S.

Contact information

Practice address
1135 MORTON ST, MATTAPAN, MA 02126-2834
(617) 533-2400
(617) 533-2401
Mailing address
1135 MORTON ST, MATTAPAN, MA 02126-2834
(617) 533-2300
(617) 533-2341

Taxonomy

Speciality
Code
Description
License number
State
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
166491
MA
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
166491
MA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
166491
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
166491
TUFTS
MA
05
1892819
MA
01
PN0539
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/29/2006
Last updated
09/03/2021
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