National Provider Identifier
Mary Gwynne Tillotson, PMHNP
Mary Gwynne Tillotson, PMHNP is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner in Niagara Falls, NY and a listed phone number of (716) 278-4541.
Profile Overview
- NPI
- 1780284869
- Provider Type
- Individual
- Primary Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Enumeration Date
- October 28, 2020
- Last Updated
- January 20, 2022
Practice Location
- 621 10Th St
- Niagara Falls, NY 14301-1813
Phone: (716) 278-4541
Specialties
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
Full Record
- NPI
- 1780284869
- Entity Type
- Individual
- Last Name
- Tillotson
- First Name
- Mary
- Middle Name
- Gwynne
- Credential
- PMHNP
- Provider Other Last Name
- Cohill
- Provider Other First Name
- Mary
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 621 10Th St
- Mailing City
- Niagara Falls
- Mailing State
- NY
- Mailing ZIP Code
- 14301-1813
- Mailing Country
- US
- Mailing Phone
- (716) 278-4541
- Practice Street Address
- 621 10Th St
- Practice City
- Niagara Falls
- Practice State
- NY
- Practice ZIP Code
- 14301-1813
- Practice Country
- US
- Practice Phone
- (716) 278-4541
- Practice Fax
- (716) 278-4544
- Enumeration Date
- October 28, 2020
- Last Updated
- January 20, 2022
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- January 20, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)