Provider Demographics
NPI:1144575978
Name:EVERETT, AMY L (RNFA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:EVERETT
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 KENNEDY MEMORIAL DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4535
Mailing Address - Country:US
Mailing Address - Phone:207-877-7477
Mailing Address - Fax:207-877-7171
Practice Address - Street 1:295 KENNEDY MEMORIAL DR
Practice Address - Street 2:SUITE 6
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4535
Practice Address - Country:US
Practice Address - Phone:207-877-7477
Practice Address - Fax:207-877-7171
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN53775163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant