MARY DESALLE GNP NPI 1427034396

NPI Information

NPI: 1427034396
Provider Name: MARY DESALLE, GNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Address:
655 MAIN ST
SACO, ME
ZIP 04072
Phone: (207) 602-3571
Get Directions

Mary Desalle, GNP is a gerontology nurse practitioner in Saco, ME. Mary Desalle, GNP NPI is 1427034396. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

655 MAIN ST
SACO, ME
ZIP 04072-543
Phone: (207) 602-3571
Fax: (207) 602-3573

The enumeration date for this NPI number is 12/21/2005 and was last updated on 2/5/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	R026628	MAINE	No
2	363LG0600X	Nurse Practitioner	Gerontology	AP081312	MAINE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100072	OTHER	MAINE	BCBS
2	MN5036	OTHER	MAINE	HPHC
3	304310001	OTHER	MAINE	CIGNA
4	1427034396	MEDICAID	MAINE
5	2735452	OTHER	MAINE	AETNA
6	500017332	OTHER	MAINE	RR MEDICARE
7	S29951	MEDICARE UPIN	MAINE
8	NP0685	MEDICARE ID-TYPE UNSPECIFIED	MAINE
9	NP0685	MEDICARE PIN
10	S29951	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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