Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | CNP91003 | ME |
NPI | 1013155779 |
---|---|
Provider Name | Claire F Mortimer |
First Address | Brooklin, ME 04616-0184 |
Second Address | Blue Hill, ME 04614-6408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 31/03/2016 |