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Individual

LILIA NEICHTADT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
716 STEVENS AVE, 716 STEVENS AVE, PORTLAND, ME 04103-2656
(207) 221-4516
Mailing address
157 GRANT ST, APT 26, PORTLAND, ME 04101-2154
(616) 633-4074

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4704278781
MI

Other

Enumeration date
07/21/2016
Last updated
07/21/2016
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