Individual
TRACY EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 706-3280
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 706-3280
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP081420
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260520099
—
ME
Enumeration date
01/16/2006
Last updated
12/29/2024
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