Gardner, Michelle A

Gardner, Michelle A is an individual health care provider with primary practice located at 489 State St , Bangor ME 04401-6616. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse First Assistant, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gardner, Michelle A can be contacted via phone (207) 973-7000.

Contact Information

Primary practice address
489 State St Bangor ME 04401-6616
Phone: (207) 973-7000
Fax: (207) 973-7394
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse First Assistant 163WR0006X R032905 Maine
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP081584 Maine

Profile Details

NPI number 1366488892
LBN Legal business name Gardner, Michelle A
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Apr 10th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366488892 NPPES
Maine Other 010507276 TAX ID
Maine MEDICAID 247850099 TAX ID
Maine Other 100544 TAX ID

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