Lisa L Bulthuis, NP
Nurse Practitioner, Family in South Portland, ME. Individual provider (NPI-1).
NPI number1689636607
StatusActive
Last updated in NPPESNov 7, 2017
Details
- NPI
- 1689636607
- Entity type
- Individual (NPI-1)
- Name
- Lisa L Bulthuis
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 5, 2006
- Last updated
- Nov 7, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | CNP81553 | ME | Yes |
Practice location
100 Foden Rd, WestSuite 100
South Portland, ME 04106
Phone 207-523-3904 · Fax 207-523-8588
Mailing address
100 Gannett DriveSuite C
South Portland, ME 04106
Phone 207-828-0361 · Fax 207-874-1483
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