| Doctor Name: | PAULA ANN TAN |
| NPI Number: | 1184640799 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | R050590 |
| Business Practice Address: | 735 Wilson Street Brewer, ME - 04412 |
| Business Phone Number: | 2079891567 |
| Business Fax Number: | 2079470435 |
| Mailing Address: | Po Box 1599, Penobscot Community Health Center BANGOR |
| State: | ME |
| Postal Code: | 044021599 |
| Phone Number: | 2079455247 |
| Fax Number: | 2079470435 |
| NPI Enumeration Date: | 07/15/2006 |
| NPI Last Update Date: | 06/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R050590 |
| 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: | |