Provider Demographics
NPI:1457487290
Name:GIMLER, THERESE MARIE (NP)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:MARIE
Last Name:GIMLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 NEWELL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-3581
Mailing Address - Country:US
Mailing Address - Phone:508-699-6235
Mailing Address - Fax:
Practice Address - Street 1:MASS GENERAL HOSPITAL
Practice Address - Street 2:55 FRUIT ST
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-724-5110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209573163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse