Healthcare Provider Details

I. General information

NPI: 1891594271
Provider Name (Legal Business Name): SHANNON ACHORN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COMMONS DR
ROCKLAND ME
04841-5544
US

IV. Provider business mailing address

865 PINNACLE RD
LIBERTY ME
04949-3524
US

V. Phone/Fax

Practice location:
  • Phone: 207-466-8788
  • Fax:
Mailing address:
  • Phone: 207-542-7402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP241796
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: