Healthcare Provider Details

I. General information

NPI: 1053550038
Provider Name (Legal Business Name): LYNNE SIGNORE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 MAIN ST
SPRINGVALE ME
04083-1409
US

IV. Provider business mailing address

PO BOX 1010
SACO ME
04072-1010
US

V. Phone/Fax

Practice location:
  • Phone: 207-324-1500
  • Fax: 207-490-5263
Mailing address:
  • Phone: 207-282-1500
  • Fax: 207-283-0473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberR055089
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: