Healthcare Provider Details

I. General information

NPI: 1790994887
Provider Name (Legal Business Name): ANNIE M APT-BRACKETT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLEASANT POINT HEALTH CENTER 11 BACK ROAD
PERRY ME
04667
US

IV. Provider business mailing address

30 POSU LANE
PERRY ME
04667
US

V. Phone/Fax

Practice location:
  • Phone: 207-853-0644
  • Fax: 207-853-6230
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR041864
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: