Healthcare Provider Details

I. General information

NPI: 1134131493
Provider Name (Legal Business Name): CECI ZEREGA, RN, MSN, CS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ROUTE 1
YARMOUTH ME
04096-4711
US

IV. Provider business mailing address

531 LEDGE RD
YARMOUTH ME
04096-7524
US

V. Phone/Fax

Practice location:
  • Phone: 207-846-0191
  • Fax:
Mailing address:
  • Phone: 207-846-0191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR036043
License Number StateME

VIII. Authorized Official

Name: CECI ZEREGA
Title or Position: PRESIDENT
Credential: RN, MSN, CS
Phone: 207-846-0191