Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | CNP181197 | ME |
NPI | 1003395302 |
---|---|
Provider Name | Sarah Elizabeth Price |
First Address | South Portland, ME 04106-5900 |
Second Address | Yarmouth, ME 04096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2018 |
Last Update Date | 19/11/2018 |