Individual
MARY ANN GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
029774-23
NH
363LP2300X
Primary Care Nurse Practitioner
Primary
CNP81271
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871601948
—
ME
05
—
3075766
—
NH
01
—
500022875
RR MEDICARE
NH
01
—
P00991109
RR MEDICARE
ME
Enumeration date
08/28/2006
Last updated
03/06/2019
Update your record
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