Individual
LAURA BETH WILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG, APRN-CNP
Contact information
Practice address
818 CONGRESS ST, PORTLAND, ME 04102-3112
(207) 773-8161
Mailing address
75 GLENRIDGE, PORTLAND, ME 04102-1845
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
CNP231503
ME
Other
Enumeration date
09/14/2023
Last updated
11/07/2024
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