MEDICARE: MARK VECKENSTEDT MSN, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN88181	ME

General Provider Information

NPI Number	:	1306798491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK VECKENSTEDT MSN, RN

Provider Business Mailing Address
First Line	:	10 LEA AVE STE 760
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37210-3541
Country	:	US
Telephone Number	:	201-526-8484
Fax Number	:	615-610-0749

Provider Business Practice Location Address
First Line	:	83 BOULDER RDG
Second Line	:
City	:	HOLLIS CENTER
State	:	ME
Zip	:	04042-3646
Country	:	US
Telephone Number	:	201-526-8484
Fax Number	:	615-610-0749

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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