Individual
MS. LORI A NILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 BRAMHALL STREET, PORTLAND, ME 04102
(207) 662-2934
(207) 662-6389
Mailing address
PO BOX 16023, LEWISTON, ME 04243-9503
(207) 396-8600
(603) 692-6040
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0859
NH
363A00000X
Physician Assistant
PA-620
ME
363A00000X
Physician Assistant
Primary
PA620
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30332527
—
NH
05
—
3071700
—
NH
01
—
P01038297
RAILROAD MEDICARE
NH
Enumeration date
12/29/2005
Last updated
01/08/2015
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