Individual
COURTNEY IRENE MACCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
CNP251297
ME
363LG0600X
Gerontology Nurse Practitioner
CNP251297
ME
Other
Enumeration date
06/26/2025
Last updated
08/05/2025
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