Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Mar 13, 2020
License(s)
CNP191278 (ME)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 93 CAMPUS AVE STE G025 | Lewiston, ME 04240-6030 | 207-333-4799 |
| MAILING | PO BOX 95000 LBX 7650 | Philadelphia, PA 19195-0001 |
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