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1326017070
LOIS TIEDEKEN
PORTLAND, ME
NPI
1326017070
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: ME 022855)
Enumeration Date
2006-03-15
Last Update Date
2010-11-23
Business Address
MS. LOIS TIEDEKEN ANP
84 MARGINAL WAY SUITE 800
PORTLAND, ME 04101
Phone number: 207-774-5816
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Mailing Address
MS. LOIS TIEDEKEN ANP
100 FODEN RD , WEST STE 203
SOUTH PORTLAND, ME 04106-2327
Phone number: 207-828-0361
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