Individual
MS. AMY L LISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
22 BRAMHALL STREET, PORTLAND, ME 04102
(207) 662-4380
(207) 662-6783
Mailing address
19 NORWOOD STREET, PORTLAND, ME 04103
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R041892
ME
Other
Enumeration date
10/02/2006
Last updated
11/21/2008
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