TINA MARIE BLACKLEY

BANGOR, ME
NPI1962937417
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: ME  CNP171038)
Enumeration Date2017-04-21
Last Update Date2019-12-06
Business Address
TINA MARIE BLACKLEY APRN FNP-C
900 BROADWAY
BANGOR, ME 04401
Phone number: 207-907-3300
Mailing Address
TINA MARIE BLACKLEY APRN FNP-C
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT PO BOX 7291
LEWISTON, ME 04243-7291
Phone number: 207-777-8560
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