Healthcare Provider Details

I. General information

NPI: 1922685403
Provider Name (Legal Business Name): MONICA PELLETIER SCHOENBAUM APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 SPURWINK AVE
CAPE ELIZABETH ME
04107-9604
US

IV. Provider business mailing address

155 SPURWINK AVE
CAPE ELIZABETH ME
04107-9604
US

V. Phone/Fax

Practice location:
  • Phone: 207-767-2174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP211037
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: