Healthcare Provider Details

I. General information

NPI: 1497662142
Provider Name (Legal Business Name): EMMA MACEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SCHOOL OF NURSING 5724 DUNN HALL
ORONO ME
04469-5724
US

IV. Provider business mailing address

285 E SIDE RD
SORRENTO ME
04677-3104
US

V. Phone/Fax

Practice location:
  • Phone: 207-581-1865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN78097
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: