Individual
MS. COURTNEY L. ANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106-1999
(207) 773-1728
(207) 772-4062
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA001142
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433501099
—
ME
Enumeration date
09/30/2008
Last updated
02/13/2012
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