Individual
LISA MADGE GRINDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMH-NP
Contact information
Practice address
175 UNION ST., SUITE C, BANGOR, ME 04401
(207) 944-3356
(207) 433-1038
Mailing address
175 UNION ST., SUITE C, BANGOR, ME 04401
(207) 944-3356
(207) 433-1038
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP081803
ME
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R036574
ME
Other
Enumeration date
12/18/2006
Last updated
05/30/2012
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