Individual
MELINDA S MCINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNPC
Contact information
Practice address
735 WILSON STREET, PENOBSCOT COMMUNITY HEALTH CENTER/ EXTENDED CARE SERVIC, BREWER, ME 04412
(207) 992-2601
(207) 989-2280
Mailing address
PO BOX 1599, PENOBSCOT COMMUNITY HEALTH CENTER, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP81598
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432301999
—
ME
Enumeration date
10/11/2006
Last updated
10/11/2023
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