Healthcare Provider Details

I. General information

NPI: 1720515539
Provider Name (Legal Business Name): NANCY BACHELDER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 LEBANON RD
WINTERPORT ME
04496-4025
US

IV. Provider business mailing address

550 LEBANON RD
WINTERPORT ME
04496-4025
US

V. Phone/Fax

Practice location:
  • Phone: 207-949-5307
  • Fax:
Mailing address:
  • Phone: 207-949-5307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN32392
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: