Healthcare Provider Details

I. General information

NPI: 1326155862
Provider Name (Legal Business Name): LORRAINE M REISER FNP-C2
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 03/21/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 MAIN ST
NORTH HAVEN ME
04853-3320
US

IV. Provider business mailing address

135 MAIN ST
NORTH HAVEN ME
04853-3320
US

V. Phone/Fax

Practice location:
  • Phone: 207-867-2021
  • Fax: 207-867-2258
Mailing address:
  • Phone: 207-867-2021
  • Fax: 207-867-2258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP151136
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: