Healthcare Provider Details

I. General information

NPI: 1427022862
Provider Name (Legal Business Name): LYNN M COTE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 05/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325C KENNEDY MEMORIAL DR SUITE 1
WATERVILLE ME
04901-4565
US

IV. Provider business mailing address

325C KENNEDY MEMORIAL DR SUITE 1
WATERVILLE ME
04901-4565
US

V. Phone/Fax

Practice location:
  • Phone: 207-872-9911
  • Fax: 207-872-9112
Mailing address:
  • Phone: 207-872-9911
  • Fax: 207-872-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP081381
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR035106
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: