Healthcare Provider Details

I. General information

NPI: 1336033042
Provider Name (Legal Business Name): DARBY AMELLY NRP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 WATER STREET
AUGUSTA ME
04330
US

IV. Provider business mailing address

56 PRESCOTT RD
MANCHESTER ME
04351-3318
US

V. Phone/Fax

Practice location:
  • Phone: 207-626-2421
  • Fax:
Mailing address:
  • Phone: 843-597-5822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number32490
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: