Doctor Name: | HEIDI M ROY |
NPI Number: | 1003078080 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | CNP81911 |
Business Practice Address: | 96 Campus Drive Suite 1 Scarborough, ME - 04074 |
Business Phone Number: | 2078859905 |
Business Fax Number: | 2073965600 |
Mailing Address: | 301c Us Route One, SCARBOROUGH |
State: | ME |
Postal Code: | 040749701 |
Phone Number: | 2073968600 |
Fax Number: | 2073968632 |
NPI Enumeration Date: | 06/30/2008 |
NPI Last Update Date: | 08/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP81911 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |