Healthcare Provider Details

I. General information

NPI: 1326816281
Provider Name (Legal Business Name): NICOLE MARIE ACHORN AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE MARIE EMBLETON-ACHORN AGACNP-BC

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 GLEN COVE DR STE 101
ROCKPORT ME
04856-4235
US

IV. Provider business mailing address

4 GLEN COVE DR STE 101
ROCKPORT ME
04856-4235
US

V. Phone/Fax

Practice location:
  • Phone: 207-301-3090
  • Fax: 207-301-5295
Mailing address:
  • Phone: 207-301-3090
  • Fax: 207-301-5295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP231380
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP231380
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP231380
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: