Individual
SHAYNA CHRISTINE DIEDRICH-PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
930 CONGRESS ST, PORTLAND, ME 04102-3032
(207) 662-1535
(207) 761-3021
Mailing address
930 CONGRESS ST, PORTLAND, ME 04102-3032
(207) 662-1535
(207) 761-3021
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN2314195
MA
363LA2100X
Acute Care Nurse Practitioner
CNP251857
ME
363LG0600X
Gerontology Nurse Practitioner
Primary
CNP251857
ME
Other
Enumeration date
11/10/2023
Last updated
03/02/2026
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