Provider Demographics
NPI:1871472712
Name:GILLETT, MASHELL (APRN)
Entity type:Individual
Prefix:
First Name:MASHELL
Middle Name:
Last Name:GILLETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-6811
Mailing Address - Country:US
Mailing Address - Phone:517-375-9957
Mailing Address - Fax:
Practice Address - Street 1:5820 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-6811
Practice Address - Country:US
Practice Address - Phone:517-375-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95244045163WC0200X
FL9488060163WC0200X
MI4704285739163WC0200X
FL11039748363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine