Individual
NICOLE T. GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2589
Mailing address
77 JASPER ST, SCARBOROUGH, ME 04074-9282
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
182003
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNM182003
ME LICENSE
ME
Enumeration date
12/12/2013
Last updated
05/17/2022
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