Individual
P R GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
386 STANLEY ST, FALL RIVER, MA 02720-6009
(508) 675-1054
(508) 324-7777
Mailing address
386 STANLEY ST, FALL RIVER, MA 02720-6009
(508) 675-1054
(508) 324-7777
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN2273593
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21600339
NCBDE
—
Enumeration date
10/12/2016
Last updated
10/12/2016
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