Healthcare Provider Details

I. General information

NPI: 1770417354
Provider Name (Legal Business Name): ALISON LYN PAINE AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MAIN ST
LEWISTON ME
04240-7041
US

IV. Provider business mailing address

265 KNOWLES RD
BELGRADE ME
04917-3903
US

V. Phone/Fax

Practice location:
  • Phone: 207-576-9965
  • Fax:
Mailing address:
  • Phone: 207-576-9965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP251915
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: