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General NPI Number Information
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NPI Number | 1497627657
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Entity Type | Organization
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Legal Business Name | APOTHEOSIS HEALTH
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 4 UNION PLZ STE 3
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City | BANGOR
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State | ME
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Zip | 04401-4881
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Country | US
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Telephone | 207-952-8784
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Fax | 207-543-4502
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Provider Business Mailing Address
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Address Line | 4 UNION PLZ STE 3
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City | BANGOR
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State | ME
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Zip | 04401-4881
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Country | US
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Telephone | 207-952-8784
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Fax | 207-543-4502
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Authorized Official
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Title or Position | FNP
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Name | ALESSANDRA TUTTLE
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Credential |
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Telephone | 207-952-8784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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