BACK COVE MIDWIVES NPI 1770895187

NPI Information

BACK COVE MIDWIVES is an obstetrics and gynecology nurse practitioner in Portland, ME. BACK COVE MIDWIVES NPI is 1770895187. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

527 OCEAN AVE
PORTLAND, ME
ZIP 04103-972
Phone: (207) 871-0666

The provider's authorized official is Eileen Grillo .
The authorized official title is Owner and has the following contact phone number (207) 871-0666.

The CLIA number assigned to this NPI record is 20D1011525 - other practitioner with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/14/2010 and was last updated on 7/14/2010.

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:

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