Individual
AMIE FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 873-1098
(207) 861-5461
Mailing address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 873-1098
(207) 861-5461
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP211610
ME
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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