Individual
MARY M SCANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
37 COLLEGE AVE, 110 UPTON HALL, GORHAM, ME 04038-1032
(207) 780-5411
(207) 780-5032
Mailing address
75 OAK RIDGE RD, KENNEBUNKPORT, ME 04046-5128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
032127-23-05
NH
363LA2200X
Adult Health Nurse Practitioner
R053144
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30010527
—
NH
Enumeration date
06/02/2006
Last updated
10/03/2007
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