Individual
SHIRLEY HEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
134 CONGRESS ST, PORTLAND, ME 04101
(207) 874-8784
Mailing address
389 CONGRESS ST, ROOM 307, PORTLAND, ME 04101-3509
(207) 874-8784
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R014002
ME
Other
Enumeration date
03/22/2007
Last updated
07/09/2007
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