Individual
MS. HEATHER ELISABETH BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
163 EDWARDS ST, PORTLAND, ME 04102-2539
(619) 401-3712
Mailing address
163 EDWARDS ST, PORTLAND, ME 04102-2539
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
622397
CA
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Enumeration date
03/12/2007
Last updated
08/06/2015
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