Individual
LUCY A MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
161 MARGINAL WAY, PORTLAND, ME 04101-2438
(207) 773-7964
Mailing address
161 MARGINAL WAY, PORTLAND, ME 04101-2438
(207) 773-7964
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP81279
ME
Other
Enumeration date
06/03/2006
Last updated
03/07/2024
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