Individual
MISS DANA L. EUSTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
33 SEWALL ST, PORTLAND, ME 04102-2603
(207) 828-2100
(207) 828-2190
Mailing address
PO BOX 1260, PORTLAND, ME 04104-1260
(207) 828-2100
(207) 828-2190
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
R029817
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041103
ANTHEM RNFA STAR NO.
ME
Enumeration date
07/26/2006
Last updated
07/08/2007
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