NPI 1366488892 · live from the CMS NPI Registry
Michelle A Gardner, FNP-BC
Nurse Practitioner, Family in Bangor, ME. National Provider Identifier 1366488892, active.
NPI record
| NPI | 1366488892 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 489 State St, Bangor, ME 04401 |
| Practice phone | 207-973-7000 |
| Mailing address | 43 Whiting Hill Rd, Suite 300, Brewer, ME 04412 |
| Enumerated | June 22, 2006 |
| Last updated | April 10, 2020 |
| Sole proprietor | No |
| Other names | Michelle Harris |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Registered Nurse First Assistant | 163WR0006X | R032905 (ME) |
| Nurse Practitioner, Family primary | 363LF0000X | AP081584 (ME) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.