Healthcare Provider Details

I. General information

NPI: 1770078966
Provider Name (Legal Business Name): STEPHANIE WHITAKER-SEAVEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 02/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PETER DANA POINT ROAD
INDIAN TWP ME
04668
US

IV. Provider business mailing address

PO BOX 97
PRINCETON ME
04668
US

V. Phone/Fax

Practice location:
  • Phone: 207-796-2321
  • Fax: 207-796-2195
Mailing address:
  • Phone: 207-796-2321
  • Fax: 207-796-2195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN63223
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN63223
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP241792
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: