Bulthuis, Lisa L

Bulthuis, Lisa L is an individual health care provider with primary practice located at 100 Foden Rd, West Suite 100, South Portland ME 04106. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bulthuis, Lisa L can be contacted via phone (207) 523-3904.

Contact Information

Primary practice address
100 Foden Rd, West Suite 100 South Portland ME 04106
Phone: (207) 523-3904
Fax: (207) 523-8588
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP81553 Maine

Profile Details

NPI number 1689636607
LBN Legal business name Bulthuis, Lisa L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Nov 7th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689636607 NPPES
Maine Other E400409706 MEDICARE
Maine Other E400409710 MEDICARE

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