Individual
MARYANN W WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
887 CONGRESS ST, SUITE 320, SCARBOROUGH, ME 04102-3103
(207) 662-5522
(207) 662-5527
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP081559
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281530099
—
ME
05
—
30347697
—
NH
Enumeration date
08/31/2006
Last updated
12/01/2014
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