Healthcare Provider Details

I. General information

NPI: 1275409344
Provider Name (Legal Business Name): AMY BETH DAMBOISE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 NORTHPORT AVE
BELFAST ME
04915-6103
US

IV. Provider business mailing address

18 JESSE ROBBINS RD
BELFAST ME
04915-7510
US

V. Phone/Fax

Practice location:
  • Phone: 207-505-4123
  • Fax:
Mailing address:
  • Phone: 207-356-0289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN85646
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: