Provider Demographics
NPI:1902917669
Name:ISLAND HEALTH SERVICES
Entity Type:Organization
Organization Name:ISLAND HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTICTIONER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:207-766-2929
Mailing Address - Street 1:PO BOX 52
Mailing Address - Street 2:87 CENTRAL AVE
Mailing Address - City:PEAKS ISLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04108-0052
Mailing Address - Country:US
Mailing Address - Phone:207-766-2929
Mailing Address - Fax:207-766-5073
Practice Address - Street 1:87 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PEAKS ISLAND
Practice Address - State:ME
Practice Address - Zip Code:04108-0052
Practice Address - Country:US
Practice Address - Phone:207-766-2929
Practice Address - Fax:207-766-5073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERO35850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
048923OtherANTHEM BC/BS
POO272282OtherRAILROAD MEDICARE
POO272282OtherRAILROAD MEDICARE
048923OtherANTHEM BC/BS