Doctor Name: | MARILYN L MICHAUD |
NPI Number: | 1013987106 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | CNP81403 |
Business Practice Address: | 900 Broadway Bangor, ME - 044011900 |
Business Phone Number: | 2079073300 |
Business Fax Number: | 2079071923 |
Mailing Address: | 900 Broadway, BANGOR |
State: | ME |
Postal Code: | 044011900 |
Phone Number: | 2079073300 |
Fax Number: | 2079071923 |
NPI Enumeration Date: | 01/23/2006 |
NPI Last Update Date: | 05/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP81403 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |