MALIA HADDOCK (NPI# 1285231217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285231217 |
| Entity Type | Individual |
| Full Name | MALIA HADDOCK |
| Credential | PMHNP |
| Practice Address |
22 Bramhall St Portland ME 04102-3134 |
| Practice Telephone | 2076620001 |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CNP201404 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
22 BRAMHALL ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-3134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641355 | Suzanne Maynard | Specialist | 22 Bramhall St, Dept of Anesthesiology, Portland, ME 04102 | 2005-07-05 |
| 1902406135 | Barbara Lewis-armstrong | Social Worker | 22 Bramhall St, Portland, ME 04102-3175 | 2020-10-27 |
| 1972118222 | Morgan O'brien | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-09-14 |
| 1295349900 | Natalie Margaret Petrone | Occupational Therapist | 22 Bramhall St, Portland, ME 04102-3175 | 2020-09-01 |
| 1467065565 | Mandi Ann Horwath | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-28 |
| 1922610492 | Diana Christine Hubbell | Registered Nurse | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-17 |
| 1790393023 | Rami Waked | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2020-07-22 |
| 1871117143 | Lesley Raley | Pharmacist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-06-03 |
| 1023638707 | Rebecca Naomi Glass | Physical Therapist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-04-22 |
| 1952930133 | Stephen Wolff | Physician Assistant | 22 Bramhall St, Portland, ME 04102-3134 | 2020-04-08 |
| Find all providers in the same location | ||||
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
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| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
| 1346802733 | Compass Psychiatric Wellness LLC | Nurse Practitioner | 4300 Ne Fremont St Ste 260, Portland, OR 97213-1100 | 2019-07-05 |
| 1548721871 | Cooke Therapy Pllc | Nurse Practitioner | 1125 Se Madison St Ste 102, Portland, OR 97214-3600 | 2019-03-28 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1467969220 | Nw Mind-body Wellness, LLC | Nurse Practitioner | 16986 Nw Lynch Ln, Portland, OR 97229-1221 | 2018-01-02 |
| 1811441348 | Anthony Hoy | Nurse Practitioner | 5562 Se Pine St, Portland, OR 97215-1276 | 2016-08-12 |
| 1700241254 | Jacqueline J Cole | Nurse Practitioner | 5228 Ne Hoyt St Ste 300, Portland, OR 97213-3055 | 2015-12-29 |
| Find all providers in PORTLAND | ||||
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| 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.