MELODY L BOULTON (NPI# 1013931492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013931492 |
| Entity Type | Individual |
| Full Name | MELODY L BOULTON |
| Credential | PMHCNS-BC |
| Practice Address |
413 Ludlow St Portland ME 04102-1544 |
| Practice Telephone | 2078710013 |
| Mailing Telephone | 2078710013 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2013-03-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
R026582 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 299140099 | 05 |
| Street Address |
413 LUDLOW ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366658049 | Annette Harriet Goodman | Clinical Nurse Specialist | 367 Us Route One, Falmouth, ME 04105-1350 | 2007-05-16 |
| 1265597793 | Andrea Bretz Savitz | Clinical Nurse Specialist | 86 Sawyer Notch Rd, Andover, ME 04216-6027 | 2006-12-26 |
| 1437192382 | Paulette T. Gosselin | Clinical Nurse Specialist | 134 Gray Rd, Falmouth, ME 04105-2049 | 2006-06-14 |
| 1730398272 | Lynn Janice Schwarz | Clinical Nurse Specialist | 89 Western Ave, Augusta, ME 04330-7227 | 2007-05-22 |
| 1720157589 | Patricia E Buls | Clinical Nurse Specialist | 460 Main St, Lewiston, ME 04240 | 2006-11-07 |
| 1932111382 | Ceci Zerega | Clinical Nurse Specialist | 500 Route 1, Yarmouth, ME 04096-4711 | 2006-08-13 |
| 1134131493 | Ceci Zerega, Rn, Msn, Cs, Inc | Clinical Nurse Specialist | 500 Route 1, Yarmouth, ME 04096-4711 | 2006-08-13 |
Please comment or provide details below to improve the information on MELODY L BOULTON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.