Individual
MARY ANN BOULOS-LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
77 HARRIS ST, AUBURN, ME 04210-4671
(207) 782-6827
(207) 376-0090
Mailing address
PO BOX 4140, BOSTON, MA 02241-0001
(207) 777-4111
(207) 783-6660
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R037527
ME
163WS0200X
School Registered Nurse
R037527
ME
363LF0000X
Family Nurse Practitioner
Primary
AP081959
ME
Other
Enumeration date
10/23/2008
Last updated
10/29/2008
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