Healthcare Provider Details

I. General information

NPI: 1548961857
Provider Name (Legal Business Name): DORIS ELISABETH MEEHAN APRN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 TRUDY CIR
OLD ORCHARD BEACH ME
04064-4180
US

IV. Provider business mailing address

4 TRUDY CIR
OLD ORCHARD BEACH ME
04064-4180
US

V. Phone/Fax

Practice location:
  • Phone: 760-458-3833
  • Fax:
Mailing address:
  • Phone: 760-458-3833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberCNS214002
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: