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NPI Profile for MARY DESALLE in SACO, ME.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner |
| NPI Number | 1427034396 |
|
| Status | Active | |
| Credentials | GNP (Gerontological Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 12/21/2005 | |
| Last updated | 02/05/2013 - About 13 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MARY DESALLE
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MARY DESALLE, GNP