Basic Information
| Provider Information | |||||||||
| NPI: | 1053512178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANCLEMENTE | ||||||||
| FirstName: | HARRIET | ||||||||
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| Credential: | PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 ORGANUG RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 039091306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082773389 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 SHAPE DR | ||||||||
| Address2: | |||||||||
| City: | KENNEBUNK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040436601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074678930 | ||||||||
| FaxNumber: | 2079858459 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2007 | ||||||||
| LastUpdateDate: | 04/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 142120 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.