Individual provider · Type 1 NPI
Mary Desalle, GNP
Gerontology Nurse Practitioner · Saco, ME
NPI number
1427034396
Active
Practice location
655 Main St
Saco, ME 04072-1543
Fax (207) 602-3573
Mailing address
PO Box 284
Brattleboro, VT 05302-0284
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R026628 (ME) |
| Gerontology Nurse Practitioner Primary | 363LG0600X | AP081312 (ME) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1427034396
Mary Desalle, GNP's National Provider Identifier is 1427034396, issued on Dec 21, 2005. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Saco, ME. The record was last updated on Feb 5, 2013.