Healthcare Provider Details

I. General information

NPI: 1366168387
Provider Name (Legal Business Name): HILARY SPROUL AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VA CTR BLDG 200
AUGUSTA ME
04330-6795
US

IV. Provider business mailing address

487 HALLOWELL RD
CHELSEA ME
04330-1207
US

V. Phone/Fax

Practice location:
  • Phone: 207-623-8411
  • Fax:
Mailing address:
  • Phone: 207-458-0046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SE0003X
TaxonomyEmergency Clinical Nurse Specialist
License NumberCNP221129
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: