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General NPI Number Information
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NPI Number | 1831903020
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Entity Type | Individual
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Provider Name | LAUREN LE LOISELLE NP
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Gender | Female
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 417 STATE ST STE 121
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City | BANGOR
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State | ME
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Zip | 04401-6630
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Country | US
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Telephone | 207-973-4266
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Fax |
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Provider Business Mailing Address
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Address Line | 42 SIDNEY BLVD
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City | HAMPDEN
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State | ME
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Zip | 04444-1418
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Country | US
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Telephone | 207-974-7374
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | CNP241815
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License Number State | ME
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