Individual
CAROLYN K GOTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
735 WILSON ST, BREWER, ME 04412
(207) 945-5247
(207) 990-1248
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RO35933
ME
363LF0000X
Family Nurse Practitioner
Primary
AP081480
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256450099
—
ME
Enumeration date
06/21/2005
Last updated
07/08/2010
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