Healthcare Provider Details

I. General information

NPI: 1578447827
Provider Name (Legal Business Name): ABIGAIL LEIGH PULLIS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1263 ROOSEVELT TRL STE 6
RAYMOND ME
04071-6684
US

IV. Provider business mailing address

52 RIDGEVIEW RD
HARRISON ME
04040-3059
US

V. Phone/Fax

Practice location:
  • Phone: 207-613-6814
  • Fax:
Mailing address:
  • Phone: 207-595-8167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP251404
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: