Unknown Individual – Nurse Practitioner, NPI 1942279732
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
100 FODEN ROAD EAST
SUITE 201
SOUTH PORTLAND, ME 04106
Phone: (207) 828-0361
Fax: (207) 874-1483
Type: Mailing
1685, Congress Street, Stroudwater, Portland, Cumberland County, Maine, 04102, United States
STROUDWATER PEDIATRICS
PORTLAND, ME 04102
Phone: (207) 774-4092
Fax: (207) 774-6024
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04106)
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