Healthcare Provider Details

I. General information

NPI: 1194823948
Provider Name (Legal Business Name): JOYCE E PHILBROOK RN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOYCE E HALLSEY RN-C

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HIGH ST
SKOWHEGAN ME
04976-1828
US

IV. Provider business mailing address

30 HIGH ST
SKOWHEGAN ME
04976-1828
US

V. Phone/Fax

Practice location:
  • Phone: 207-474-8368
  • Fax: 207-474-7794
Mailing address:
  • Phone: 207-474-8368
  • Fax: 207-474-7794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR022017
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: