Individual
MARISA CROMMETT STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
443 CONGRESS ST FL 2, PORTLAND, ME 04101-3531
(866) 476-1321
(802) 660-9437
Mailing address
784 HERCULES DR STE 110, COLCHESTER, VT 05446-8049
(802) 210-5953
(802) 660-9438
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
081681-23
NH
363LG0600X
Gerontology Nurse Practitioner
081681-23
NH
363LP2300X
Primary Care Nurse Practitioner
081681-23
NH
363LW0102X
Women's Health Nurse Practitioner
Primary
081681-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3122699
—
NH
Enumeration date
11/14/2019
Last updated
09/23/2021
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