Provider Demographics
NPI:1396371555
Name:MAHER, GISELLE GREENAN (RN)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:GREENAN
Last Name:MAHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 FERNCROFT CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-5518
Mailing Address - Country:US
Mailing Address - Phone:925-683-4039
Mailing Address - Fax:925-683-4039
Practice Address - Street 1:520 FERNCROFT CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-5518
Practice Address - Country:US
Practice Address - Phone:925-683-4039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA604626163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse