Organization · NPI-2

Back Cove Midwives

Nurse Practitioner, Obstetrics & Gynecology · Portland, ME

NPI number1770895187
StatusActive
Last updated in NPPESJul 14, 2010

Details

NPI
1770895187
Entity type
Organization (NPI-2)
Legal business name
Back Cove Midwives
Organization subpart
No
Enumeration date
Jul 14, 2010
Last updated
Jul 14, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LX0001X Nurse Practitioner, Obstetrics & Gynecology–MEYes

Practice location

527 Ocean Ave
Portland, ME 04103-4972

Phone 207-871-0666

Mailing address

527 Ocean Ave
Portland, ME 04103-4972

Phone 207-871-0666

Authorized official

Eileen Grillo
Owner
2078710666

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