Individual
LEA J WYGANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
40 AIRPORT RD, WATERVILLE, ME 04901-4524
(207) 742-8381
Mailing address
15 WINCHESTER ST APT 2, FAIRFIELD, ME 04937-1314
(207) 509-8763
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN14196
ME
Other
Enumeration date
12/23/2015
Last updated
01/30/2023
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