Basic Information
| Provider Information | |||||||||
| NPI: | 1801527957 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANFILIPPO | ||||||||
| FirstName: | CASEY | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | APRN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 GANNETT DR STE C | ||||||||
| Address2: | |||||||||
| City: | SOUTH PORTLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 041065900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078280361 | ||||||||
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| Practice Location | |||||||||
| Address1: | 259 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | YARMOUTH | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040964703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078469013 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2022 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN63388 | ME | N | Nursing Service Providers | Registered Nurse | 363L00000X | CNP221248 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.