Individual
DYLAN T OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
175 FORE RIVER PKWY, PORTLAND, ME 04102-2779
(207) 879-3000
Mailing address
PO BOX 441, CARIBOU, ME 04736-0441
(207) 551-5699
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA203062
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/31/2018
Last updated
12/13/2022
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