Individual
JULIANNE B ONTENGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2934
(207) 662-6389
Mailing address
301 US ROUTE 1, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
RN46386
ME
363LA2200X
Adult Health Nurse Practitioner
Primary
CNP81058
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267670099
—
ME
05
—
30343060
—
NH
Enumeration date
10/04/2006
Last updated
09/24/2024
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