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General NPI Number Information
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NPI Number | 1770383887
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Entity Type | Organization
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Legal Business Name | MAINELY DIABETES AND ENDOCRINE CARE PLLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 76 MAPLE ST
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City | MONMOUTH
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State | ME
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Zip | 04259-7007
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Country | US
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Telephone | 207-405-7500
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Fax | 207-405-7500
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Provider Business Mailing Address
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Address Line | 76 MAPLE ST
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City | MONMOUTH
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State | ME
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Zip | 04259-7007
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Country | US
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Telephone | 207-405-7500
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Fax | 207-405-7500
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DOMINIQUE UVA
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Credential | FNP-C
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Telephone | 207-405-7500
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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 |
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License Number State |
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