Provider Demographics
NPI:1376674861
Name:MCKIE, GILLIAN MARY (APNC- NP)
Entity Type:Individual
Prefix:
First Name:GILLIAN
Middle Name:MARY
Last Name:MCKIE
Suffix:
Gender:F
Credentials:APNC- NP
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Mailing Address - Street 1:120 ALBANY STREET
Mailing Address - Street 2:TOWER 2, 7TH FLOOR
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2126
Mailing Address - Country:US
Mailing Address - Phone:732-937-8537
Mailing Address - Fax:732-937-8941
Practice Address - Street 1:1 ROBERT WOOD JOHNSON PLACE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08903
Practice Address - Country:US
Practice Address - Phone:732-235-7840
Practice Address - Fax:732-235-7048
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2011-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA051658363L00000X
NJ26NJ00021100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA051658OtherLICENSE