MEDICARE: GRACE MERRIFIELD PEASE CPM

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	176B00000X	Midwife	CPM772	ME

General Provider Information

NPI Number	:	1811606692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE MERRIFIELD PEASE CPM

Provider Business Mailing Address
First Line	:	20 FARM LN
Second Line	:
City	:	CORNISH
State	:	ME
Zip	:	04020-3270
Country	:	US
Telephone Number	:	207-205-5263
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 RIVER RD
Second Line	:
City	:	LIMINGTON
State	:	ME
Zip	:	04049-3709
Country	:	US
Telephone Number	:	207-329-2111
Fax Number	:

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

Provider Enumeration Date	:	11/21/2022
Last Update Date	:	11/21/2022

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Directions to “ GRACE MERRIFIELD PEASE CPM” Practice Location

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