Organization
MARY DELOIS,F.N.P.,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY DELOIS (F.N.P.)
(207) 761-4700
Entity
Organization
Contact information
Practice address
260 WESTERN AVENUE, SOUTH PORTLAND, ME 04106
(207) 761-4700
Mailing address
125 BANCROFT STREET, PORTLAND, ME 04102
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R023829
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R023829
NURDING LISCENCE
ME
Enumeration date
05/03/2007
Last updated
12/12/2007
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