Keeshen, Gayle

Keeshen, Gayle is an individual health care provider with primary practice located at 1011 Forest Ave , Portland ME 04103-3304. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Keeshen, Gayle can be contacted via phone (207) 781-8881.

Contact Information

Primary practice address
1011 Forest Ave Portland ME 04103-3304
Phone: (207) 781-8881
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X OT1641 Maine

Profile Details

NPI number 1962624767
LBN Legal business name Keeshen, Gayle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2007
Last updated Feb 21st, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962624767 NPPES
Maine MEDICAID OT1641

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