Stephanie Malm, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN85679 Issued in ME

Practice address

100 Brickhill Ave Ste 303
South Portland, ME 04106-1999

Phone

(207) 874-2141

NPI assigned

Dec 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Dwyer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: stephanie.malm.p1@direct.portlandchc.nextgenshare.com

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1609692961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE STE 303",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE STE 303",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999",
            "telephone_number": "207-874-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALM",
        "first_name": "STEPHANIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN85679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "DWYER",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Lauren S Manchester, LADC
• Micaela Manganello
• Adam Mangiafico, EMT-P
• Alexandra Cinthia Mann, DDS
• Donald Joseph Manship, MC.P.C.

• Registered Nurse in South Portland, ME
• Providers in South Portland, ME by specialty
• Registered Nurse in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.