Healthcare Provider Details

I. General information

NPI: 1871746727
Provider Name (Legal Business Name): SHANNON L CURTIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 COMMERCE PARK COASTAL HEALTH CENTER
ELLSWORTH ME
04605-3383
US

IV. Provider business mailing address

50 UNION STREET MAINE COAST MEMORIAL HOSPITAL
ELLSWORTH ME
04605
US

V. Phone/Fax

Practice location:
  • Phone: 207-667-2422
  • Fax: 207-667-0135
Mailing address:
  • Phone: 207-664-5304
  • Fax: 207-664-5305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP081962
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: