Provider Demographics
NPI:1013155779
Name:MORTIMER, CLAIRE F (FNP, MSN)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:F
Last Name:MORTIMER
Suffix:
Gender:F
Credentials:FNP, MSN
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:F
Other - Last Name:MORTIMER-MAIBETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC, MSN
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:BROOKLIN
Mailing Address - State:ME
Mailing Address - Zip Code:04616-0184
Mailing Address - Country:US
Mailing Address - Phone:207-479-7428
Mailing Address - Fax:877-801-7493
Practice Address - Street 1:6 EAST BLUE HILL RD.
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:ME
Practice Address - Zip Code:04614-6408
Practice Address - Country:US
Practice Address - Phone:207-479-7428
Practice Address - Fax:877-801-7493
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP91003363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner