Provider Demographics
NPI:1972118982
Name:GILLIGAN, MARGUERITE ANNE (RN,IBCLC)
Entity type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:ANNE
Last Name:GILLIGAN
Suffix:
Gender:F
Credentials:RN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 GRANVILLE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1133
Mailing Address - Country:US
Mailing Address - Phone:415-305-3497
Mailing Address - Fax:
Practice Address - Street 1:137 GRANVILLE WAY
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1133
Practice Address - Country:US
Practice Address - Phone:415-305-3497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA441325163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse