Healthcare Provider Details

I. General information

NPI: 1750262309
Provider Name (Legal Business Name): ALLISSA JEAN GURNEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 MAIN STREET 2
RANGELEY ME
04970
US

IV. Provider business mailing address

PO BOX 281
RANGELEY ME
04970-0281
US

V. Phone/Fax

Practice location:
  • Phone: 207-754-8011
  • Fax: 949-860-3944
Mailing address:
  • Phone: 207-754-8011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP251598
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: