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1962937417
TINA MARIE BLACKLEY
BANGOR, ME
NPI
1962937417
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: ME CNP171038)
Enumeration Date
2017-04-21
Last Update Date
2019-12-06
Business Address
TINA MARIE BLACKLEY APRN FNP-C
900 BROADWAY
BANGOR, ME 04401
Phone number: 207-907-3300
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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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