Healthcare Provider Details

I. General information

NPI: 1003073024
Provider Name (Legal Business Name): MEGAN ELIZABETH SMETANA CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 US ROUTE 1 STE C
SCARBOROUGH ME
04074-7174
US

IV. Provider business mailing address

71 US ROUTE 1 STE C
SCARBOROUGH ME
04074-7174
US

V. Phone/Fax

Practice location:
  • Phone: 207-883-5532
  • Fax: 207-883-5552
Mailing address:
  • Phone: 207-883-5532
  • Fax: 207-883-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP121012
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number274045
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCNP121012
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberCNP121012
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: