Mary Ann Boulos-Lord, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP081959 Issued in ME

Practice address

77 Harris St
Auburn, ME 04210-4671

Phone

(207) 782-6827

Fax

(207) 376-0090

NPI assigned

Oct 23, 2008

Last updated

Oct 29, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1285887158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4140",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022410001",
            "telephone_number": "207-777-4111",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HARRIS ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042104671",
            "telephone_number": "207-782-6827",
            "fax_number": "207-376-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOS-LORD",
        "first_name": "MARY ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "R037527",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "ME",
            "license": "R037527",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "AP081959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Walter Boegemann, DPT
• Tyler Boilard, PHARMD
• Amy Borens, RDH
• Holly Frey Bosse, FNP-C
• Lisa Jean Boucher, P.A.-C
• Michelle Boutin, PA
• Laura Kathryn Bradbury, LCSW
• Courtney Karol Bradeen, LCSW
• Robert Henry Brainerd Jr., LATC, CSCS
• Douglas W Breunig, LCSW

• Family Nurse Practitioner in Auburn, ME
• Providers in Auburn, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.