Individual
MRS. ELISE MICHELLE AMICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
716 STEVENS AVE, PORTLAND, ME 04103-2693
(207) 221-4516
Mailing address
23 WESTMORE AVE, CUMBERLAND, ME 04021-3054
(207) 664-4457
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
RNA233057
ME
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
10/08/2023
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