Individual
LEAH SHELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(415) 832-9243
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
CNP211204
ME
363LA2100X
Acute Care Nurse Practitioner
R214764
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/18/2019
Last updated
08/11/2021
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