Individual provider · Type 1 NPI
Samuel Benedict Maynard, APRN
Family Nurse Practitioner · New London, CT
NPI number
1124671961
Active
Practice location
1 Shaws Cv
New London, CT 06320-4902
Mailing address
749 9th St Unit 203
Durham, NC 27705-1060
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 162343 (CT) |
| Family Nurse Practitioner Primary | 363LF0000X | 8305 (CT) |
Family Nurse Practitioner: Definition to come...
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About NPI 1124671961
Samuel Benedict Maynard, APRN's National Provider Identifier is 1124671961, issued on Jul 22, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in New London, CT. The record was last updated on Jul 22, 2019.