MEDICARE: MRS. HILARY SPROUL AGACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SE0003X	Emergency Clinical Nurse Specialist	CNP221129	ME

General Provider Information

NPI Number	:	1366168387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HILARY SPROUL AGACNP

Provider Business Mailing Address
First Line	:	487 HALLOWELL RD
Second Line	:
City	:	CHELSEA
State	:	ME
Zip	:	04330-1207
Country	:	US
Telephone Number	:	207-458-0046
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 VA CTR BLDG 200
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-6795
Country	:	US
Telephone Number	:	207-623-8411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	05/13/2026

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