Provider Demographics
NPI:1750945986
Name:GILLIHAN, KATIE (FNP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:GILLIHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04903-0727
Mailing Address - Country:US
Mailing Address - Phone:207-660-9926
Mailing Address - Fax:207-660-9901
Practice Address - Street 1:4 CLEMENT WAY
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:ME
Practice Address - Zip Code:04917-4370
Practice Address - Country:US
Practice Address - Phone:207-495-3323
Practice Address - Fax:207-495-3353
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP211196363LP0808X, 363LF0000X
MERN67508163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty