Healthcare Provider Details
I. General information
NPI: 1679986319
Provider Name (Legal Business Name): ANNA CLAIRE GONYEA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/10/2014
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
175 W BROADWAY
LINCOLN ME
04457-4000
US
IV. Provider business mailing address
175 W BROADWAY
LINCOLN ME
04457-4000
US
V. Phone/Fax
- Phone: 207-794-6700
- Fax:
- Phone: 207-794-6700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | CNP251873 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: