Healthcare Provider Details

I. General information

NPI: 1255414827
Provider Name (Legal Business Name): BARBARA MANSIR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ROUTE 201
FAIRFIELD ME
04937-3303
US

IV. Provider business mailing address

248 STATE ST
BREWER ME
04412-1519
US

V. Phone/Fax

Practice location:
  • Phone: 207-453-1330
  • Fax: 207-453-1333
Mailing address:
  • Phone: 207-989-2034
  • Fax: 207-989-5971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number035356
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: