Provider Demographics
NPI:1518493634
Name:GILMAN, ADAM THOMAS (APRN)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:THOMAS
Last Name:GILMAN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MCGREGOR ST STE 105
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3732
Mailing Address - Country:US
Mailing Address - Phone:603-663-6252
Mailing Address - Fax:603-663-6257
Practice Address - Street 1:88 MCGREGOR ST STE 105
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3732
Practice Address - Country:US
Practice Address - Phone:603-663-6252
Practice Address - Fax:603-663-6257
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH067829-21363LP0808X
CT8841363LP0808X
NH067829-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health