Healthcare Provider Details

I. General information

NPI: 1710037783
Provider Name (Legal Business Name): MAUREEN SMITH NHCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 NOTCH RD
HIRAM ME
04041-3345
US

IV. Provider business mailing address

721 NOTCH RD
HIRAM ME
04041-3345
US

V. Phone/Fax

Practice location:
  • Phone: 207-712-5375
  • Fax:
Mailing address:
  • Phone: 207-712-5375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1027
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: