Healthcare Provider Details

I. General information

NPI: 1134145733
Provider Name (Legal Business Name): NADINE M LAMOREAU FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NADINE M HAY FNP

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 HIGH ST
FORT FAIRFIELD ME
04742-1021
US

IV. Provider business mailing address

23 HIGH ST
FORT FAIRFIELD ME
04742-1021
US

V. Phone/Fax

Practice location:
  • Phone: 207-768-4753
  • Fax: 207-768-4748
Mailing address:
  • Phone: 207-768-4753
  • Fax: 207-768-4748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR025732
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: