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Individual

VANESSA MARIE ILIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC, APRN

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2934
(207) 662-6389
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2934
(207) 662-6389

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11280
CT
363LA2100X
Acute Care Nurse Practitioner
Primary
CNP251221
ME
363LG0600X
Gerontology Nurse Practitioner
CNP251221
ME

Other

Enumeration date
10/27/2021
Last updated
01/05/2026
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