Basic Information
Provider Information
NPI: 1275820250
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GLASSPOOL
FirstName: NORA
MiddleName: GRIFFIN
NamePrefix: MRS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 31 FRONT ST
Address2:  
City: WATERVILLE
State: ME
PostalCode: 049016626
CountryCode: US
TelephoneNumber: 2078731181
FaxNumber: 2078731186
Practice Location
Address1: 31 FRONT ST
Address2:  
City: WATERVILLE
State: ME
PostalCode: 049016626
CountryCode: US
TelephoneNumber: 2078731181
FaxNumber: 2078731186
Other Information
ProviderEnumerationDate: 06/29/2011
LastUpdateDate: 05/05/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD20252MEY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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