Individual
MR. BENJAMIN CHAD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
6 TELCOM DR, BANGOR, ME 04401-3072
(207) 947-0147
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP171185
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNP171185
STATE LICENSE
ME
01
—
E400443631
PTAN
ME
Enumeration date
10/11/2011
Last updated
03/07/2023
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