Individual
BRIANNA GULLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
400 WESTERN AVE, SOUTH PORTLAND, ME 04106-1704
(207) 774-7111
Mailing address
25 ROCKLINN DR, WINDHAM, ME 04062-4993
(207) 650-3894
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN75656
ME
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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