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General NPI Number Information
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NPI Number | 1164165791
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Entity Type | Individual
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Provider Name | ERIC CHRISTOFFERSON FNPC
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Gender | Male
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 11/09/2025
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Provider Practice Location Address
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Address Line | 900 BROADWAY
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City | BANGOR
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State | ME
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Zip | 04401-1900
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Country | US
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Telephone | 207-907-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 360 BROADWAY
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City | BANGOR
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State | ME
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Zip | 04401-3979
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Country | US
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Telephone | 207-907-1000
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP221238
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License Number State | ME
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