MEDICARE: LORRAINE M REISER FNP-C2

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	CNP151136	ME

General Provider Information

NPI Number	:	1326155862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRAINE M REISER FNP-C2

Provider Business Mailing Address
First Line	:	135 MAIN ST
Second Line	:
City	:	NORTH HAVEN
State	:	ME
Zip	:	04853-3320
Country	:	US
Telephone Number	:	207-867-2021
Fax Number	:	207-867-2258

Provider Business Practice Location Address
First Line	:	135 MAIN ST
Second Line	:
City	:	NORTH HAVEN
State	:	ME
Zip	:	04853-3320
Country	:	US
Telephone Number	:	207-867-2021
Fax Number	:	207-867-2258

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	03/21/2025

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