Organization
MELISSA N LIBBY FNP LLC
Active
Organization
MELISSA N LIBBY FNP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA N LIBBY FNP (PRESIDENT)
(207) 761-4700
Entity
Organization
Contact information
Practice address
100 BRICKHILL AVE, SUITE 304, SOUTH PORTLAND, ME 04106-1999
(207) 761-4700
(207) 761-4744
Mailing address
100 BRICKHILL AVE, SUITE 304, SOUTH PORTLAND, ME 04106-1999
(207) 761-4700
(207) 761-4744
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
CNP81250
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417350901
—
ME
Enumeration date
09/29/2014
Last updated
04/16/2015
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