Individual
SARAH CHISHOLM SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-0111
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-0111
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
CNP181213
ME
363L00000X
Nurse Practitioner
RN264145
MA
Other
Enumeration date
03/08/2010
Last updated
07/17/2019
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