| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 22 White St, Rockland, Maine |
| Authorized Official Name and Position | Nicolle Baade (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 2075208823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
22 White St Rockland ME 04841-2978 Ph: (207) 301-6996 | 22 White St Rockland ME 04841-2978 Ph: (207) 301-6996 |
| NPI Number | 1346070117 |
|---|---|
| Provider Enumeration Date | 08/06/2024 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 7719410315 |
|---|---|
| Medicare Enrollment ID | O20241104000741 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346070117 | NPI | - | NPPES |
| Provider Name | Vanessa Elizabeth Shields-haas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982281143 PECOS PAC ID: 1951751924 Enrollment ID: I20240103002304 |
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