Individual
LISA BELANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
37 COLLEGE AVE, 125 UPTON HALL, GORHAM, ME 04038-1032
(207) 780-5411
Mailing address
11 LISAS WAY, NORTH YARMOUTH, ME 04097-6075
(207) 657-2299
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP81142
ME
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R021136
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305647
AETNA
ME
05
—
324760099
—
ME
01
—
39362
HARVARD PILGRIM
ME
01
—
M2048203
CIGNA
ME
Enumeration date
03/20/2007
Last updated
05/25/2016
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