| Doctor Name: | PEGGY A OUELLETTE |
| NPI Number: | 1003099961 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FPMH-NP |
| License Number: | R039058 |
| Business Practice Address: | 329 Bath Rd Brunswick, ME - 040112609 |
| Business Phone Number: | 8004343000 |
| Business Fax Number: | |
| Mailing Address: | 12 Pinebrook Ln, PORTLAND |
| State: | ME |
| Postal Code: | 041021313 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/13/2007 |
| NPI Last Update Date: | 12/13/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R039058 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |