MEDICARE: MS. VICKY LEAH OUELLETTE-SPERREY FNP-C

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	363LF0000X	Family Nurse Practitioner	CNP211552	ME

General Provider Information

NPI Number	:	1568122679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICKY LEAH OUELLETTE-SPERREY FNP-C

Provider Business Mailing Address
First Line	:	732 MAIN ST
Second Line	:
City	:	PRESQUE ISLE
State	:	ME
Zip	:	04769-2254
Country	:	US
Telephone Number	:	207-623-8411
Fax Number	:	207-626-4704

Provider Business Practice Location Address
First Line	:	732 MAIN ST
Second Line	:
City	:	PRESQUE ISLE
State	:	ME
Zip	:	04769-2254
Country	:	US
Telephone Number	:	207-623-8411
Fax Number	:	207-626-4704

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

Provider Enumeration Date	:	12/30/2021
Last Update Date	:	06/02/2026

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