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General NPI Number Information
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NPI Number | 1891779492
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Entity Type | Individual
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Provider Name | SUSAN R LORD NP
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Gender | Female
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 11/16/2010
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Provider Practice Location Address
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Address Line | 22 WHITE ST
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City | ROCKLAND
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State | ME
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Zip | 04841-2978
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Country | US
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Telephone | 207-594-3114
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Fax | 207-594-3108
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Provider Business Mailing Address
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Address Line | PO BOX 866
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City | ROCKLAND
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State | ME
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Zip | 04841-0866
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Country | US
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Telephone | 207-594-3114
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Fax | 207-594-3108
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R-023932
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | R-023932
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License Number State | ME
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