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Individual

AMY IRENE STAFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
22 BRAMHALL ST BLDG ROOM1147, PORTLAND, ME 04102-3175
(207) 662-6773
Mailing address
72 MUNJOY ST APT 1, PORTLAND, ME 04101-2096
(206) 579-1025

Taxonomy

Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
CNS204003
ME

Other

Enumeration date
06/09/2022
Last updated
06/09/2022
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