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Contact Information

MARY A GAGNON, APRN
31 COLCORD ST
SOUTH BERWICK, ME03908-1004
 Phone: 207-384-4949
 Fax: 207-384-4273
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MARY A GAGNON · (Female)

NPI Number 1871601948
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 08/28/2006
Last updated 03/06/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • ME License # CNP81271
  • NH License # 029774-23
  • ME Medicaid 1871601948
  • NH Medicaid 3075766
  • ME Other P00991109 RR MEDICARE
  • NH Other 500022875 RR MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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