Healthcare Provider Details

I. General information

NPI: 1538882634
Provider Name (Legal Business Name): CATHERINA TRIBOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 MAIN ST
ORONO ME
04473-3446
US

IV. Provider business mailing address

151 CAPITOL ST STE 4
AUGUSTA ME
04330-6262
US

V. Phone/Fax

Practice location:
  • Phone: 207-942-0669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2000518317
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN64687
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: