Healthcare Provider Details
I. General information
NPI: 1437670916
Provider Name (Legal Business Name): ROBYN BIRD AGPCNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/05/2017
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
108 CENTRE ST STE 200
BATH ME
04530-2550
US
IV. Provider business mailing address
108 CENTRE ST STE 200
BATH ME
04530-2550
US
V. Phone/Fax
- Phone: 207-386-1800
- Fax: 207-517-6915
- Phone: 207-386-1800
- Fax: 207-517-6915
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | CNP191263 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: