Healthcare Provider Details

I. General information

NPI: 1356988653
Provider Name (Legal Business Name): ANN MARY LAWLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 12/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 HINCKLEY RD
CANAAN ME
04924-3308
US

IV. Provider business mailing address

545 HINCKLEY RD
CANAAN ME
04924-3308
US

V. Phone/Fax

Practice location:
  • Phone: 207-431-2878
  • Fax:
Mailing address:
  • Phone: 207-431-2878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: