MARY DESALLE (NPI# 1427034396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427034396 |
| Entity Type | Individual |
| Full Name | MARY DESALLE |
| Credential | GNP |
| Practice Address |
655 Main St Saco ME 04072-1543 |
| Mailing Address |
Po Box 284 Brattleboro VT 05302-0284 |
| Practice Telephone | 2076023571 |
| Practice Fax Number | 2076023573 |
| Mailing Telephone | 2077842554 |
| Mailing Fax Number | 2077775363 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2013-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AP081312 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
R026628 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | CIGNA | 304310001 | 01 |
| ME | RR MEDICARE | 500017332 | 01 |
| ME | BCBS | 100072 | 01 |
| ME | 1427034396 | 05 | |
| ME | AETNA | 2735452 | 01 |
| ME | HPHC | MN5036 | 01 |
| Street Address |
655 MAIN ST |
| City | SACO |
| State | ME |
| Zip Code | 04072-1543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699240226 | Cortney Elizabeth Binette | Emergency Medicine | 655 Main St, Saco, ME 04072-1699 | 2018-10-10 |
| 1124508924 | Mainehealth | Clinic/Center | 655 Main St, Saco, ME 04072-1543 | 2018-08-21 |
| 1588150783 | Ross Hanley | Physician Assistant | 655 Main St, Saco, ME 04072-1543 | 2018-07-11 |
| 1477042406 | Tricia E Garrett | Physician Assistant | 655 Main St, Saco, ME 04072-1543 | 2018-05-04 |
| 1316297690 | Nichole C Reader | Nurse Practitioner | 655 Main St, Saco, ME 04072-1543 | 2012-09-14 |
| 1255690228 | Southern Maine Health Care | Clinic/Center | 655 Main St, Saco, ME 04072-1543 | 2012-05-11 |
| 1356608368 | Korrie B Beverley-waters | Neuromusculoskeletal Medicine & OMM | 655 Main St, Saco, ME 04072 | 2012-04-15 |
| 1689953762 | Tara Jones Molloy | Nurse Practitioner | 655 Main St, Saco, ME 04072-1543 | 2011-08-08 |
| 1134310618 | Garrett B Edwards | Neuromusculoskeletal Medicine & OMM | 655 Main St, Saco, ME 04072-1543 | 2007-08-08 |
| 1336342955 | Colleen Mayo | Nurse Practitioner | 655 Main St, Saco, ME 04072-1543 | 2007-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962043786 | Maine Safe Ride Services | Non-emergency Medical Transport (VAN) | 32 Water St, Suite 4, Saco, ME 04072 | 2019-10-02 |
| 1821656810 | Rebecca Akins | Occupational Therapist | Mainely Kidz Pt, 895 Portland Rd., Saco, ME 04072 | 2019-06-04 |
| 1376045070 | Ashley A Cardurns | Nurse Practitioner | 15 Moody St, Saco, ME 04072 | 2018-03-08 |
| 1861990103 | Morgan Dube | Specialist/Technologist | 21 Evergreen Dr, Saco, ME 04072 | 2018-01-31 |
| 1639603004 | Jodi Morris | Massage Therapist | 10 School Street 2nd Floor, Saco, ME 04072 | 2017-04-12 |
| 1073812665 | Elisabeth Geralyn Holdsworth | Specialist | 895 Portland Road, Saco, ME 04072 | 2011-03-22 |
| 1336378181 | Ah Inn Associates LLC | Assisted Living Facility | 100 Harbor Drive, Saco, ME 04072 | 2009-07-14 |
| 1326286634 | Bambi Morgan Delattre | Counselor | 655 Maine Street, Saco, ME 04072 | 2009-01-23 |
| 1215054143 | Meret Claudia Bainbridge | Acupuncturist | 35 Storer St, Saco, ME 04072 | 2007-03-24 |
| 1023104155 | Lynne M Tetreault | Pediatrics | 5 Scamman St., Saco, ME 04072 | 2006-10-05 |
| Find all providers in zip 04072 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982680187 | Patricia Holt | Nurse Practitioner | 655 Main St, Saco, ME 04072-1543 | 2005-12-20 |
| 1285610493 | Nancy M Nickerson | Nurse Practitioner | 655 Main St, Saco, ME 04072-1543 | 2005-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285281311 | Anne Kenyon Smith | Nurse Practitioner | 22 Station Ave # 101, Brunswick, ME 04011-2092 | 2019-08-22 |
| 1336696590 | Nathaniel Anderson | Nurse Practitioner | 266 E Elm St, Yarmouth, ME 04096-7116 | 2016-09-06 |
| 1083008098 | Maine Life Care Retirement Community | Nurse Practitioner | 15 Piper Road, Scarborough, ME 04074-7541 | 2015-03-27 |
| 1144327024 | Elizabeth Mary Barthmaier | Nurse Practitioner | Amedisys Palliative Care, 54 Atlantic Place, South Portland, ME 04106 | 2006-09-20 |
| 1093366239 | Danielle Rice | Nurse Practitioner | 149 North St, Waterville, ME 04901-4974 | 2019-09-27 |
| 1619463072 | Kristie Jean Murphy | Nurse Practitioner | 50 Marquis Rd, Freeport, ME 04032-6477 | 2018-07-09 |
| 1053780312 | Elise Scala | Nurse Practitioner | 56 Baribeau Dr, Brunswick, ME 04011-3251 | 2015-09-16 |
| 1164765640 | Tanya L Sleeper | Nurse Practitioner | 163 Van Buren Rd, Caribou, ME 04736-3567 | 2013-04-03 |
| 1033157227 | Nan M Boucher | Nurse Practitioner | 99 Campus Ave, Suite 201, Lewiston, ME 04240-6045 | 2006-06-02 |
Please comment or provide details below to improve the information on MARY DESALLE.
| 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.