Healthcare Provider Details

I. General information

NPI: 1659085264
Provider Name (Legal Business Name): SARAH IRENE HAND RN, IBCLC, CCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 MOUNT HOPE AVE
BANGOR ME
04401-4212
US

IV. Provider business mailing address

433 MOUNT HOPE AVE
BANGOR ME
04401-4212
US

V. Phone/Fax

Practice location:
  • Phone: 207-745-0509
  • Fax:
Mailing address:
  • Phone: 207-745-0509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-108535
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN64678
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: