Healthcare Provider Details

I. General information

NPI: 1528395720
Provider Name (Legal Business Name): DARCI R BUBAR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 STATE ST STE 421
BANGOR ME
04401-6639
US

IV. Provider business mailing address

43 WHITING HILL RD STE 300
BREWER ME
04412-1006
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-5293
  • Fax:
Mailing address:
  • Phone: 207-973-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP91059
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP91059
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: