Gothard, Carolyn K

Gothard, Carolyn K is an individual health care provider with primary practice located at 735 Wilson St , Brewer ME 04412. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gothard, Carolyn K can be contacted via phone (207) 945-5247.

Contact Information

Primary practice address
735 Wilson St Brewer ME 04412
Fax: (207) 990-1248
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP081480 Maine
Nursing Service Providers / Registered Nurse 163W00000X RO35933 Maine

Profile Details

NPI number 1437155884
LBN Legal business name Gothard, Carolyn K
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Jul 8th, 2010 - about 15 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 1437155884 NPPES
Maine MEDICAID 256450099

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