Healthcare Provider Details

I. General information

NPI: 1285003277
Provider Name (Legal Business Name): MIKAELA B RUBENSTEIN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2015
Last Update Date: 11/22/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MAIN ST
TURNER ME
04282
US

IV. Provider business mailing address

180 CHURCH HILL RD STE 1
LEEDS ME
04263-3418
US

V. Phone/Fax

Practice location:
  • Phone: 207-524-3501
  • Fax: 207-225-2692
Mailing address:
  • Phone: 207-524-3501
  • Fax: 207-524-2093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number089970-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2376314
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP181050
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN80837-NP-C
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN254699
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: