MARY DESALLE


Address: 655 Main St, Saco, ME 04072-1543
Phone: 2076023571

MARY DESALLE (NPI# 1427034396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427034396
Entity Type Individual
Full Name MARY DESALLE
Credential GNP
Practice Address 655 Main St
Saco
ME 04072-1543
Mailing Address Po Box 284
Brattleboro
VT 05302-0284
Practice Telephone 2076023571
Practice Fax Number 2076023573
Mailing Telephone 2077842554
Mailing Fax Number 2077775363
Enumeration Date 2005-12-21
Last Update Date 2013-02-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
AP081312 ME Physician Assistants & Advanced Practice Nursing Providers
N 363LG0600X Nurse Practitioner
Specialization: Gerontology
R026628 ME Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
ME CIGNA 304310001 01
ME RR MEDICARE 500017332 01
ME BCBS 100072 01
ME 1427034396 05
ME AETNA 2735452 01
ME HPHC MN5036 01

Office Location

Street Address 655 MAIN ST
City SACO
State ME
Zip Code 04072-1543

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699240226 Cortney Elizabeth Binette Emergency Medicine 655 Main St, Saco, ME 04072-1699 2018-10-10
1124508924 Mainehealth Clinic/Center 655 Main St, Saco, ME 04072-1543 2018-08-21
1588150783 Ross Hanley Physician Assistant 655 Main St, Saco, ME 04072-1543 2018-07-11
1477042406 Tricia E Garrett Physician Assistant 655 Main St, Saco, ME 04072-1543 2018-05-04
1316297690 Nichole C Reader Nurse Practitioner 655 Main St, Saco, ME 04072-1543 2012-09-14
1255690228 Southern Maine Health Care Clinic/Center 655 Main St, Saco, ME 04072-1543 2012-05-11
1356608368 Korrie B Beverley-waters Neuromusculoskeletal Medicine & OMM 655 Main St, Saco, ME 04072 2012-04-15
1689953762 Tara Jones Molloy Nurse Practitioner 655 Main St, Saco, ME 04072-1543 2011-08-08
1134310618 Garrett B Edwards Neuromusculoskeletal Medicine & OMM 655 Main St, Saco, ME 04072-1543 2007-08-08
1336342955 Colleen Mayo Nurse Practitioner 655 Main St, Saco, ME 04072-1543 2007-06-10
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1962043786 Maine Safe Ride Services Non-emergency Medical Transport (VAN) 32 Water St, Suite 4, Saco, ME 04072 2019-10-02
1821656810 Rebecca Akins Occupational Therapist Mainely Kidz Pt, 895 Portland Rd., Saco, ME 04072 2019-06-04
1376045070 Ashley A Cardurns Nurse Practitioner 15 Moody St, Saco, ME 04072 2018-03-08
1861990103 Morgan Dube Specialist/Technologist 21 Evergreen Dr, Saco, ME 04072 2018-01-31
1639603004 Jodi Morris Massage Therapist 10 School Street 2nd Floor, Saco, ME 04072 2017-04-12
1073812665 Elisabeth Geralyn Holdsworth Specialist 895 Portland Road, Saco, ME 04072 2011-03-22
1336378181 Ah Inn Associates LLC Assisted Living Facility 100 Harbor Drive, Saco, ME 04072 2009-07-14
1326286634 Bambi Morgan Delattre Counselor 655 Maine Street, Saco, ME 04072 2009-01-23
1215054143 Meret Claudia Bainbridge Acupuncturist 35 Storer St, Saco, ME 04072 2007-03-24
1023104155 Lynne M Tetreault Pediatrics 5 Scamman St., Saco, ME 04072 2006-10-05
Find all providers in zip 04072

Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982680187 Patricia Holt Nurse Practitioner 655 Main St, Saco, ME 04072-1543 2005-12-20
1285610493 Nancy M Nickerson Nurse Practitioner 655 Main St, Saco, ME 04072-1543 2005-12-20

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1285281311 Anne Kenyon Smith Nurse Practitioner 22 Station Ave # 101, Brunswick, ME 04011-2092 2019-08-22
1336696590 Nathaniel Anderson Nurse Practitioner 266 E Elm St, Yarmouth, ME 04096-7116 2016-09-06
1083008098 Maine Life Care Retirement Community Nurse Practitioner 15 Piper Road, Scarborough, ME 04074-7541 2015-03-27
1144327024 Elizabeth Mary Barthmaier Nurse Practitioner Amedisys Palliative Care, 54 Atlantic Place, South Portland, ME 04106 2006-09-20
1093366239 Danielle Rice Nurse Practitioner 149 North St, Waterville, ME 04901-4974 2019-09-27
1619463072 Kristie Jean Murphy Nurse Practitioner 50 Marquis Rd, Freeport, ME 04032-6477 2018-07-09
1053780312 Elise Scala Nurse Practitioner 56 Baribeau Dr, Brunswick, ME 04011-3251 2015-09-16
1164765640 Tanya L Sleeper Nurse Practitioner 163 Van Buren Rd, Caribou, ME 04736-3567 2013-04-03
1033157227 Nan M Boucher Nurse Practitioner 99 Campus Ave, Suite 201, Lewiston, ME 04240-6045 2006-06-02

Competitor

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City SACO
Zip Code 04072

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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