Individual provider · NPI-1
Amy Irene Stafford, RN
Clinical Nurse Specialist · Portland, ME
NPI number1013646512
StatusActive
Last updated in NPPESJun 9, 2022
Details
- NPI
- 1013646512
- Entity type
- Individual (NPI-1)
- Name
- Amy Irene Stafford
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 9, 2022
- Certification date
- Jun 9, 2022
- Last updated
- Jun 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 364S00000X | Clinical Nurse Specialist | CNS204003 | ME | Yes |
Practice location
22 Bramhall St Bldg Room1147Portland, ME 04102-3175
Phone 207-662-6773
Mailing address
72 Munjoy St Apt 1Portland, ME 04101-2096
Phone 206-579-1025
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.