Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | CNP141018 | ME |
NPI | 1033527411 |
---|---|
Provider Name | Gwen C Duffield |
First Address | York, ME 03909-1011 |
Second Address | Pleasant Point, ME 04667-4119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2014 |
Last Update Date | 03/01/2017 |