Provider Demographics
NPI:1588256226
Name:STONE, ISAAC MATTHEW (RN)
Entity type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:MATTHEW
Last Name:STONE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7370
Mailing Address - Country:US
Mailing Address - Phone:207-660-7463
Mailing Address - Fax:
Practice Address - Street 1:5 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-7370
Practice Address - Country:US
Practice Address - Phone:207-660-7463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN57796163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse