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General NPI Number Information
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NPI Number | 1477920080
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Entity Type | Individual
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Provider Name | LYNNE MARIE PELLETIER RN-BSN
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Gender | Female
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 3 MOUNTAINVIEW DR
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City | FORT KENT
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State | ME
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Zip | 04743-1614
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Country | US
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Telephone | 207-444-5973
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Fax | 207-444-5520
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Provider Business Mailing Address
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Address Line | PO BOX 309
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City | EAGLE LAKE
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State | ME
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Zip | 04739-0309
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Country | US
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Telephone | 207-444-5973
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Fax | 207-444-5520
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN24451
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License Number State | ME
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