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General NPI Number Information
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NPI Number | 1104786151
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE DIABETES CENTER
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 26 MALLARD DR
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City | YORK
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State | ME
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Zip | 03909-1361
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Country | US
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Telephone | 207-814-8718
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Fax |
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Provider Business Mailing Address
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Address Line | 26 MALLARD DR
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City | YORK
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State | ME
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Zip | 03909-1361
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Country | US
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Telephone | 207-814-8718
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | EMILY APPLETON
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Credential | PA-C
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Telephone | 631-664-2112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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