Individual
MR. MARY LOUISE GILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4000 JOHNSON RD, STEUBENVILLE, OH 43952-2300
(740) 264-8000
Mailing address
PO BOX 307, RICHMOND, OH 43944-0307
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100213
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0838419
—
OH
Enumeration date
01/10/2007
Last updated
07/08/2007
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