Healthcare Provider Details

I. General information

NPI: 1013909183
Provider Name (Legal Business Name): MAUREEN SUZANNE GORMAN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 HIGH ST
SABATTUS ME
04280-4240
US

IV. Provider business mailing address

33 HIGH ST
SABATTUS ME
04280-4240
US

V. Phone/Fax

Practice location:
  • Phone: 207-375-2578
  • Fax:
Mailing address:
  • Phone: 207-375-2578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberR035556
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR035556
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR035556
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: