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NPI Code Detail

MEDICARE: MANDY LYNE BRACY PMHNP

MEDICARE: MANDY LYNE BRACY PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerCNP261209ME

General Provider Information

NPI Number : 1730024779
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDY LYNE BRACY PMHNP
Provider Business Mailing Address
First Line : 25 JUNE ST
Second Line :
City : SANFORD
State : ME
Zip : 04073-2621
Country : US
Telephone Number : 207-490-7000
Fax Number : 207-490-7002
Provider Business Practice Location Address
First Line : 25 JUNE ST
Second Line :
City : SANFORD
State : ME
Zip : 04073-2621
Country : US
Telephone Number : 207-651-8076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2026
Last Update Date : 05/06/2026

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