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General NPI Number Information
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NPI Number | 1609173574
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Entity Type | Individual
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Provider Name | KAREN MARLENE GILL R.N.
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Gender | Female
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Dates
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Enumeration Date | 02/11/2011
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 1500 GENESEE STREET MENTAL HEALTH CONNECTIONS
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City | UTICA
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State | NY
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Zip | 13502-5104
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Country | US
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Telephone | 315-735-9501
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Fax |
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Provider Business Mailing Address
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Address Line | 920 ELWOOD ST
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City | ROME
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State | NY
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Zip | 13440-2933
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Country | US
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Telephone | 315-533-6097
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 329316-1
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License Number State | NY
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