Provider Demographics
NPI:1871746727
Name:CURTIS, SHANNON L (FNP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:L
Last Name:CURTIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 UNION STREET
Mailing Address - Street 2:MAINE COAST MEMORIAL HOSPITAL
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605
Mailing Address - Country:US
Mailing Address - Phone:207-664-5304
Mailing Address - Fax:207-664-5305
Practice Address - Street 1:37 COMMERCE PARK
Practice Address - Street 2:COASTAL HEALTH CENTER
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-3383
Practice Address - Country:US
Practice Address - Phone:207-667-2422
Practice Address - Fax:207-667-0135
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEAP081962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000895602Medicare PIN
ME000895601Medicare PIN