Provider Demographics
NPI:1619082427
Name:WESTBROOK, MERLE H (ANP)
Entity Type:Individual
Prefix:
First Name:MERLE
Middle Name:H
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-282-9180
Practice Address - Street 1:30 W COLE RD
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9458
Practice Address - Country:US
Practice Address - Phone:207-282-3349
Practice Address - Fax:207-282-6099
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER037700363LA2200X
MECNP81041363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433243299Medicaid
MENP124901Medicare PIN
MES59784Medicare UPIN