Provider Demographics
NPI:1609752062
Name:INDEPENDENT WOUND CARE PLLC
Entity type:Organization
Organization Name:INDEPENDENT WOUND CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMMERCIAL OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-615-9940
Mailing Address - Street 1:91 AUBURN ST STE J
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-6014
Mailing Address - Country:US
Mailing Address - Phone:207-615-9940
Mailing Address - Fax:
Practice Address - Street 1:19 BRANDON STREET
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103
Practice Address - Country:US
Practice Address - Phone:207-615-9940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty