Stevens, Marisa Crommett
Stevens, Marisa Crommett is an individual health care provider with primary practice located at 443 Congress St Fl 2 , Portland ME 04101-3531. She recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Stevens, Marisa Crommett can be contacted via phone (866) 476-1321.Contact Information
Primary practice address
443 Congress St Fl 2
Portland ME 04101-3531
Phone: (866) 476-1321
Fax: (802) 660-9437
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 081681-23 | New Hampshire |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 081681-23 | New Hampshire |
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | 081681-23 | New Hampshire |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 081681-23 | New Hampshire |
Profile Details
| NPI number | 1104461151 |
|---|---|
| LBN Legal business name | Stevens, Marisa Crommett |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2019 |
| Last updated | Sep 23rd, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104461151 | NPPES |
| New Hampshire | MEDICAID | 3122699 |
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