Pennell, Nicholas D

Pennell, Nicholas D is an individual health care provider with primary practice located at 1321 Washington Ave 301, Portland ME 04103-3636. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Pennell, Nicholas D can be contacted via phone (207) 780-6565.

Contact Information

Primary practice address
1321 Washington Ave 301 Portland ME 04103-3636
Phone: (207) 780-6565
Fax: (207) 878-6565
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R049269 Maine

Profile Details

NPI number 1053368993
LBN Legal business name Pennell, Nicholas D
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Jul 25th, 2013 - about 12 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 1053368993 NPPES
New Hampshire MEDICAID 30347108
New Hampshire MEDICAID 433046299

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