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Individual

SUZANNE MAYNARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
22 BRAMHALL ST, DEPT OF ANESTHESIOLOGY, PORTLAND, ME 04102
(207) 662-4562
(207) 662-6236
Mailing address
22 BRAMHALL ST, DEPT OF ANESTHESIOLOGY, PORTLAND, ME 04102
(207) 662-4562
(207) 662-6236

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
03373921
NH
367500000X
Certified Registered Nurse Anesthetist
Primary
033739-23
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30342549
NH
Enumeration date
07/05/2005
Last updated
08/28/2008
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