Individual
JUNE FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3771
Mailing address
5 ABENAKI WAY, KENNEBUNKPORT, ME 04046-5737
(207) 967-4576
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA001067
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1044464
AETNA
ME
05
—
110230100
—
ME
01
—
ANTHEM
ANTHEM
ME
01
—
PA001067
STATE LICENCE
ME
Enumeration date
10/12/2006
Last updated
07/23/2013
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