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NPI Code Detail

MEDICARE: CHRISTINE MOULTON F.N.P

MEDICARE: CHRISTINE MOULTON F.N.P
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
1363LF0000XFamily Nurse Practitioner035412ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588643886
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE MOULTON F.N.P
Provider Business Mailing Address
First Line : 43 S LUBEC RD
Second Line :
City : LUBEC
State : ME
Zip : 04652-3620
Country : US
Telephone Number : 207-733-5541
Fax Number : 207-733-2127
Provider Business Practice Location Address
First Line : 43 S LUBEC RD
Second Line :
City : LUBEC
State : ME
Zip : 04652-3620
Country : US
Telephone Number : 207-733-5541
Fax Number : 207-733-2127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 06/29/2021

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