Healthcare Provider Details

I. General information

NPI: 1902917669
Provider Name (Legal Business Name): ISLAND HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 CENTRAL AVE
PEAKS ISLAND ME
04108-0052
US

IV. Provider business mailing address

PO BOX 52 87 CENTRAL AVE
PEAKS ISLAND ME
04108-0052
US

V. Phone/Fax

Practice location:
  • Phone: 207-766-2929
  • Fax: 207-766-5073
Mailing address:
  • Phone: 207-766-2929
  • Fax: 207-766-5073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRO35850
License Number StateME

VIII. Authorized Official

Name: NANCY L WRIGHT
Title or Position: NURSE PRACTICTIONER
Credential: FNP
Phone: 207-766-2929