Doctor Name: | NICKI J LARRABEE |
NPI Number: | 1295013365 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | CNP111032 |
Business Practice Address: | 1300 Crystal Rd Island Falls, ME - 047474369 |
Business Phone Number: | 2075282285 |
Business Fax Number: | 2075282595 |
Mailing Address: | Po Box 500, PATTEN |
State: | ME |
Postal Code: | 047650500 |
Phone Number: | 2075282285 |
Fax Number: | 2075282880 |
NPI Enumeration Date: | 07/23/2011 |
NPI Last Update Date: | 05/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP111032 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |