Doctor Name: | BLAIRE A SIEFKEN |
NPI Number: | 1073861050 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | CNP151071 |
Business Practice Address: | 24 Hospital Ln Calais, ME - 046191329 |
Business Phone Number: | 2074547521 |
Business Fax Number: | 2074543616 |
Mailing Address: | 24 Hospital Ln, CALAIS |
State: | ME |
Postal Code: | 046191329 |
Phone Number: | 2074547521 |
Fax Number: | 2074543616 |
NPI Enumeration Date: | 08/22/2012 |
NPI Last Update Date: | 07/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP151071 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |