Provider Demographics
NPI:1902199730
Name:FRYEBURG ACADEMY
Entity Type:Organization
Organization Name:FRYEBURG ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYNSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-935-2318
Mailing Address - Street 1:745 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRYEBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04037-1322
Mailing Address - Country:US
Mailing Address - Phone:207-935-3218
Mailing Address - Fax:
Practice Address - Street 1:745 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRYEBURG
Practice Address - State:ME
Practice Address - Zip Code:04037-1322
Practice Address - Country:US
Practice Address - Phone:207-935-3218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty