Stothoff, Sally S

Stothoff, Sally S is an individual health care provider with primary practice located at 180 Kennedy Memorial Dr Suite 204, Waterville ME 04901-4540. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Stothoff, Sally S can be contacted via phone (207) 872-5529.

Contact Information

Primary practice address
180 Kennedy Memorial Dr Suite 204 Waterville ME 04901-4540
Phone: (207) 872-5529
Fax: (207) 872-9219
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R024050 Maine
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP81238 Maine

Profile Details

NPI number 1366439929
LBN Legal business name Stothoff, Sally S
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated May 23rd, 2016 - 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 1366439929 NPPES
Maine MEDICAID 284350099
Maine Other P00066199
Maine Other 040915
Maine Other AA21889

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