Healthcare Provider Details

I. General information

NPI: 1447140041
Provider Name (Legal Business Name): ANNA MICHELSON DNP, APRN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNIE MICHELSON DNP, APRN, AGNP-C

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 NORTH ST
WATERVILLE ME
04901-4974
US

IV. Provider business mailing address

996 CHESTNUT ST APT 1
NEWTON UPPER FALLS MA
02464-1136
US

V. Phone/Fax

Practice location:
  • Phone: 207-873-1098
  • Fax: 207-861-5461
Mailing address:
  • Phone: 610-710-1905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP261649
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: