Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1712 | ME |
NPI | 1457336216 |
---|---|
Provider Name | Heather P Ferrill |
First Address | Biddeford, ME 04005-9422 |
Second Address | Saco, ME 04072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 01/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
413340099 | (05) | ME |
I15421 | (02) | ME |