Individual
PATRICIA FAHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
887 CONGRESS ST, SUITE 210, PORTLAND, ME 04102-3100
(207) 774-2544
(207) 774-0459
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R034517
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30343484
—
NH
05
—
431740799
—
ME
Enumeration date
01/11/2007
Last updated
01/04/2011
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