Individual
PORCHIA WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1012 UNION ST, BANGOR, ME 04401-3060
(207) 404-8100
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CNP181311
ME
363L00000X
Nurse Practitioner
Primary
GAA-NP000238
GA
390200000X
Student in an Organized Health Care Education/Training Program
L1-0050007
DE
Other
Enumeration date
12/17/2018
Last updated
04/03/2025
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