Provider Demographics
NPI:1831736354
Name:GASHLIN, LISA (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:GASHLIN
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:PO BOX 136
Mailing Address - Street 2:
Mailing Address - City:SURRY
Mailing Address - State:ME
Mailing Address - Zip Code:04684-0136
Mailing Address - Country:US
Mailing Address - Phone:207-460-6655
Mailing Address - Fax:
Practice Address - Street 1:46 BLUE HILL RD
Practice Address - Street 2:
Practice Address - City:SURRY
Practice Address - State:ME
Practice Address - Zip Code:04684-0468
Practice Address - Country:US
Practice Address - Phone:207-460-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN66260163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MERN66260OtherREGISTERED NURSE