Individual
DAWN ENNIS DECOTIIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
15 GRACELAWN RD, SUITE 103, AUBURN, ME 04210-6334
(207) 330-3950
(207) 330-3955
Mailing address
PO BOX 1638, ALBANY, NY 12201-1638
(207) 777-4111
(207) 783-6660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP081531
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245200099
—
ME
Enumeration date
06/04/2006
Last updated
07/04/2011
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