Individual
VIJAYARANI SURESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6 FARLEY RD, BRUNSWICK, ME 04011-2642
(207) 725-8079
(207) 798-4455
Mailing address
PO BOX 9746, PORTLAND, ME 04104-5040
(207) 791-3888
(207) 828-7850
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP91025
ME
Other
Enumeration date
07/27/2009
Last updated
08/10/2012
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