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General NPI Number Information
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NPI Number | 1114859444
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Entity Type | Organization
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Legal Business Name | WILD HEART HEALTHCARE
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 7 PORTLAND FARMS RD
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City | SCARBOROUGH
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State | ME
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Zip | 04074-5301
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Country | US
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Telephone | 207-522-9945
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Fax |
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Provider Business Mailing Address
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Address Line | 34 SHEFFIELD ST
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City | PORTLAND
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State | ME
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Zip | 04102-2707
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANNA MEAD
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Credential | FNP
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Telephone | 207-522-9945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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