Provider Demographics
NPI:1720066145
Name:GILMAN, MARIA T (APRN)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:T
Last Name:GILMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:T
Other - Last Name:FLANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1126 HARTFORD AVENUE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-519-1940
Mailing Address - Fax:401-351-6611
Practice Address - Street 1:1126 HARTFORD AVENUE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919
Practice Address - Country:US
Practice Address - Phone:401-519-1940
Practice Address - Fax:401-351-6611
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00627363L00000X
MA227424363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQ19329Medicare UPIN
MANP4624Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL ID#