MEDICARE: EMILY REESE FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	CNP161082	ME

General Provider Information

NPI Number	:	1962946681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY REESE FNP

Provider Business Mailing Address
First Line	:	12 HIGH ST STE 205
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-7689
Country	:	US
Telephone Number	:	207-795-2935
Fax Number	:	207-795-2319

Provider Business Practice Location Address
First Line	:	12 HIGH ST STE 205
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240
Country	:	US
Telephone Number	:	207-795-2935
Fax Number	:	207-795-2319

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2016
Last Update Date	:	01/17/2023

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