Healthcare Provider Details

I. General information

NPI: 1750351672
Provider Name (Legal Business Name): DIANNE HOLLIS LYTLE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANNE ROGERS LYTLE

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WAYMAN LANE MT DESERT ISLAND HOSPITAL & HEALTH CENTERS
BAR HARBOR ME
04609
US

IV. Provider business mailing address

PO BOX 128
MOUNT DESERT ME
04660-0128
US

V. Phone/Fax

Practice location:
  • Phone: 207-288-5081
  • Fax:
Mailing address:
  • Phone: 207-244-4049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW008100L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR018721
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: