Healthcare Provider Details

I. General information

NPI: 1376651141
Provider Name (Legal Business Name): LESLIE S YETTER RNCS PMH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 MEDICAL CENTER DR MIDCOAST HOSPITAL
BRUNSWICK ME
04011
US

IV. Provider business mailing address

123 MEDICAL CENTER DR MIDCOAST HOSPITAL
BRUNSWICK ME
04011
US

V. Phone/Fax

Practice location:
  • Phone: 207-373-6086
  • Fax: 207-373-6080
Mailing address:
  • Phone: 207-373-6086
  • Fax: 207-373-6080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR035730
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberR035730
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: