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General NPI Number Information
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NPI Number | 1730351354
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Entity Type | Organization
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Legal Business Name | ROYAL RIVER FAMILY CARE, PA
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 60 FOREST FALLS DR SUITE #1
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City | YARMOUTH
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State | ME
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Zip | 04096-6971
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Country | US
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Telephone | 207-846-0716
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Fax | 207-846-0718
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Provider Business Mailing Address
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Address Line | 60 FOREST FALLS DR SUITE #1
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City | YARMOUTH
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State | ME
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Zip | 04096-6971
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Country | US
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Telephone | 207-846-0716
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Fax | 207-846-0718
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINDA JEAN BREWSTER
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Credential | FNP
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Telephone | 207-846-0716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 030692
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License Number State | ME
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