Individual
DEBORAH R TETREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
272 CONGRESS ST., PORTLAND, ME 04101
(207) 874-2466
(207) 774-4625
Mailing address
39 WALLACE AVE, SO. PORTLAND, ME 04106
(207) 761-0650
(207) 761-8198
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R023566
ME
Other
Enumeration date
10/04/2006
Last updated
02/09/2009
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