Healthcare Provider Details

I. General information

NPI: 1073535225
Provider Name (Legal Business Name): ALLISON FAYE GELLER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON FAYE MARSHALL ARNP

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/21/2022
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SOUTHSIDE RD
YORK ME
03909-5117
US

IV. Provider business mailing address

2 SOUTHSIDE RD
YORK ME
03909-5117
US

V. Phone/Fax

Practice location:
  • Phone: 603-562-5578
  • Fax:
Mailing address:
  • Phone: 603-562-5578
  • Fax: 207-363-0503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number101-0032213
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number053064-23-03
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP111087
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: