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Organization

MARIANNE DECAIN TARRAZA NP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER S FOURNIER (CREDENTIALING BILLING REP)
(207) 312-1063
Entity
Organization

Contact information

Practice address
1000 SHORE RD, BUILDING #326, CAPE ELIZABETH, ME 04107-1916
(207) 312-1063
(207) 375-5165
Mailing address
PO BOX 2328, SOUTH PORTLAND, ME 04116-2328
(207) 312-1063
(207) 375-5165

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
CNP81164
ME

Other

Enumeration date
07/17/2012
Last updated
07/17/2012
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