Healthcare Provider Details

I. General information

NPI: 1144156456
Provider Name (Legal Business Name): CASSIDY DOYON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W HILL RD
GARDINER ME
04345-1933
US

IV. Provider business mailing address

15 PHILIPS AVE
AUGUSTA ME
04330-4354
US

V. Phone/Fax

Practice location:
  • Phone: 207-395-6066
  • Fax:
Mailing address:
  • Phone: 207-395-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP261498
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: