Healthcare Provider Details

I. General information

NPI: 1801569488
Provider Name (Legal Business Name): CORINNE LEE MALENFANT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORINNE LEE KEENE

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 SCHOOL HOUSE RD STE 26
ORLAND ME
04472-3966
US

IV. Provider business mailing address

21 SCHOOL HOUSE RD STE 26
ORLAND ME
04472-3966
US

V. Phone/Fax

Practice location:
  • Phone: 207-702-9201
  • Fax: 207-702-9194
Mailing address:
  • Phone: 207-702-9201
  • Fax: 207-702-9194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP211373
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: