Healthcare Provider Details

I. General information

NPI: 1053323360
Provider Name (Legal Business Name): SARAH PINKERTON-BONNEAU RN CERTIFIED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 US ROUTE 1
KITTERY ME
03904-5513
US

IV. Provider business mailing address

453 US ROUTE 1
KITTERY ME
03904-5513
US

V. Phone/Fax

Practice location:
  • Phone: 207-439-8391
  • Fax: 207-282-7509
Mailing address:
  • Phone: 207-439-8391
  • Fax: 207-282-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number251247
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: