Individual
MARY J GAVRILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
718 SMYTH RD, MANCHESTER, NH 03104-4124
(603) 624-4366
Mailing address
718 SMYTH RD, MANCHESTER, NH 03104-7007
(603) 624-4366
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
036369-23-03
NH
Other
Enumeration date
05/11/2006
Last updated
03/29/2016
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