Healthcare Provider Details

I. General information

NPI: 1376250068
Provider Name (Legal Business Name): TAMMIE MAY HUTCHINSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMIE MAY HAMILTON

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 FORE RIVER PKWY
PORTLAND ME
04102-2795
US

IV. Provider business mailing address

155 FORE RIVER PKWY
PORTLAND ME
04102-2795
US

V. Phone/Fax

Practice location:
  • Phone: 207-879-3190
  • Fax: 207-822-2474
Mailing address:
  • Phone: 207-879-3190
  • Fax: 207-822-2474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP221200
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: