Individual
ELIZABETH BLADES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
887 CONGRESS ST STE 100, PORTLAND, ME 04102-3100
(207) 272-2882
Mailing address
107 FROST HILL RD, PORTLAND, ME 04103-2281
(207) 272-2882
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP221625
ME
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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