Healthcare Provider Details

I. General information

NPI: 1366475097
Provider Name (Legal Business Name): JOYCE POIRIER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 02/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 FORE RIVER PKWY SUITE 440
PORTLAND ME
04102-2780
US

IV. Provider business mailing address

195 FORE RIVER PKWY SUITE 440
PORTLAND ME
04102-2780
US

V. Phone/Fax

Practice location:
  • Phone: 207-553-6920
  • Fax: 207-553-6940
Mailing address:
  • Phone: 207-553-6920
  • Fax: 207-553-6940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR028477
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: