Healthcare Provider Details

I. General information

NPI: 1851331375
Provider Name (Legal Business Name): ELIZABETH JULIA DRURY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 ST ANDREW'S LANE
BOOTHBAY HARBOR ME
04538
US

IV. Provider business mailing address

PO BOX 745
NEWCASTLE ME
04553
US

V. Phone/Fax

Practice location:
  • Phone: 207-633-7820
  • Fax: 207-633-7082
Mailing address:
  • Phone: 207-563-4146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP81960
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN54496
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: