Individual
REENA NUTAKKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 VA CTR, AUGUSTA, ME 04330-6795
(207) 623-8411
(207) 621-7316
Mailing address
10 WASHINGTON ST, WATERVILLE, ME 04901-4315
(207) 877-7100
(807) 872-6134
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R046968
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R046968
LICENSE
ME
Enumeration date
08/26/2008
Last updated
09/25/2025
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