Healthcare Provider Details

I. General information

NPI: 1447860994
Provider Name (Legal Business Name): SARA ADAIR MULVEY RN, PMHNPBC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2020
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 RAILROAD SQ STE 1
WATERVILLE ME
04901-6139
US

IV. Provider business mailing address

342 AUGUSTA RD
WINSLOW ME
04901-0788
US

V. Phone/Fax

Practice location:
  • Phone: 207-204-7064
  • Fax: 949-989-7341
Mailing address:
  • Phone: 207-453-4708
  • Fax: 207-238-6299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP251274
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN59618
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: