Provider Demographics
NPI:1013230515
Name:RAFTER, MARY S (FNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:S
Last Name:RAFTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:WISCASSET
Mailing Address - State:ME
Mailing Address - Zip Code:04578-4133
Mailing Address - Country:US
Mailing Address - Phone:207-882-6008
Mailing Address - Fax:207-882-7803
Practice Address - Street 1:66 WATER ST
Practice Address - Street 2:
Practice Address - City:WISCASSET
Practice Address - State:ME
Practice Address - Zip Code:04578-4133
Practice Address - Country:US
Practice Address - Phone:207-882-6008
Practice Address - Fax:207-882-7803
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER057032163W00000X
MECNP111050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse