Individual
ESMERALDA ANTONIA ULLOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
66 BRAMHALL ST STE G1, PORTLAND, ME 04102-3344
(207) 662-2841
Mailing address
76 FLORIDA AVE, PORTLAND, ME 04103-3810
(207) 939-8490
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP191274
ME
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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