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General NPI Number Information
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NPI Number | 1649366741
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Entity Type | Individual
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Provider Name | NANCY O GREEN CNM
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 37 PALMER ST
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City | CALAIS
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State | ME
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Zip | 04619-1305
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Country | US
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Telephone | 207-454-3307
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Fax | 207-454-3988
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Provider Business Mailing Address
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Address Line | 43 PALMER ST
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City | CALAIS
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State | ME
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Zip | 04619-1305
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Country | US
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Telephone | 207-454-8150
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Fax | 207-454-0256
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | R027181
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License Number State | ME
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