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General NPI Number Information
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NPI Number | 1083129498
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Entity Type | Individual
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Provider Name | NICOLE LYNN RAY FNP
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Gender | Female
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 01/18/2026
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Provider Practice Location Address
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Address Line | 229B MAIN ST
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City | WATERVILLE
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State | ME
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Zip | 04901-6119
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Country | US
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Telephone | 207-212-9868
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Fax | 614-818-5006
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Provider Business Mailing Address
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Address Line | 14 TRUE RD
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City | MERCER
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State | ME
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Zip | 04957-4421
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Country | US
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Telephone | 207-212-9868
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Fax | 614-818-5006
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP171186
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License Number State | ME
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