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General NPI Number Information
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NPI Number | 1720026818
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Entity Type | Individual
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Provider Name | MARY M SCANNELL ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 37 COLLEGE AVE 110 UPTON HALL
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City | GORHAM
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State | ME
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Zip | 04038-1032
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Country | US
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Telephone | 207-780-5411
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Fax | 207-780-5032
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Provider Business Mailing Address
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Address Line | 75 OAK RIDGE RD
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City | KENNEBUNKPORT
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State | ME
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Zip | 04046-5128
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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 |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 032127-23-05
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R053144
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License Number State | ME
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