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NPI Code Detail

MEDICARE: MS. BONITA JEAN AYOTTE ANP-C

MEDICARE: MS. BONITA JEAN AYOTTE ANP-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
1363LA2200XAdult Health Nurse PractitionerR014580ME

General Provider Information

NPI Number : 1609988427
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BONITA JEAN AYOTTE ANP-C
Provider Business Mailing Address
First Line : 221 FRYE RD
Second Line :
City : SOMERVILLE
State : ME
Zip : 04348-3216
Country : US
Telephone Number : 207-549-7865
Fax Number :
Provider Business Practice Location Address
First Line : VETERANS ADMINISTRATION
Second Line : 1 VA CENTER
City : TOGUS
State : ME
Zip : 04330-6796
Country : US
Telephone Number : 207-623-8411
Fax Number : 207-621-4892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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