MICHELLE A GARDNER


Address: 489 State St, Bangor, ME 04401-6616
Phone: 2079737000

MICHELLE A GARDNER (NPI# 1366488892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366488892
Entity Type Individual
Full Name MICHELLE A GARDNER
Other Name MICHELLE A. HARRIS
Credential FNP-BC
Practice Address 489 State St
Bangor
ME 04401-6616
Mailing Address 43 Whiting Hill Rd
Suite 300
Brewer
ME 04412-1005
Practice Telephone 2079737000
Practice Fax Number 2079737394
Mailing Telephone 2079735035
Mailing Fax Number 2079735042
Enumeration Date 2006-06-22
Last Update Date 2020-04-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
AP081584 ME Physician Assistants & Advanced Practice Nursing Providers
N 163WR0006X Registered Nurse
Specialization: Registered Nurse First Assistant
R032905 ME Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
ME TAX ID 010507276 01
ME 247850099 05
ME ANTHEM 100544 01

Other Providers MICHELLE GARDNER

NPI Name Taxonomy Address Enumeration
1265851703 Michelle Diann Gardner Specialist/Technologist 615 S State St, Grangeville, ID 83530-2035 2014-04-14
1891073102 Michelle A Gardner Student in an Organized Health Care Education/Training Program 3800 S 48th St, Lincoln, NE 68506-4345 2011-08-03
1316109945 Michelle N Gardner Occupational Therapist 4255 Medwell Dr., Newburgh, IN 47630 2008-06-25
1639383599 Michelle Ann Gardner Optometrist 808 Wacker Dr, Dubuque, IA 52002 2007-05-10
1447603808 Michelle E Gardner Nurse Practitioner 3730 S Pinnacle Hills Pkwy Ste 2, Rogers, AR 72758 2016-07-20
1548614928 Michelle Gardner Nurse Practitioner 400 Water Ave, Hillsboro, WI 54634-9054 2016-04-21
1831514702 Michelle Gardner Physical Therapist 4801 Springfield St, Dayton, OH 45431-1084 2014-02-28
1831450469 Michelle T Gardner Pediatrics 1001 Sam Perry Blvd, Fredericksburg, VA 22401 2012-05-30
1437231354 Michelle Huffman Gardner Family Medicine 315 E Elm St, Ste 100, Caldwell, ID 83605-4857 2006-10-19
1548299118 Michelle W Gardner Psychiatry & Neurology 656 State St, Bangor, ME 04401-5609 2006-07-03

Office Location

Street Address 489 STATE ST
City BANGOR
State ME
Zip Code 04401-6616

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790789147 Eastern Maine Medical Center General Acute Care Hospital 489 State St, Bangor, ME 04401-6616 2005-06-13
1356956239 Amanda Roberts Physician Assistant 489 State St, Bangor, ME 04401-6674 2020-09-09
1558983148 Lana Caroline Hoertz Physician Assistant 489 State St, Bangor, ME 04401-6616 2020-05-18
1427696954 Kelsey A Mcgrath Nurse Anesthetist, Certified Registered 489 State St, Bangor, ME 04401-6616 2019-12-16
1528629888 Jaclyn Young Nurse Anesthetist, Certified Registered 489 State St, Bangor, ME 04401-6616 2019-06-26
1568928018 Emily Bohm Physician Assistant 489 State St, Bangor, ME 04401-6616 2019-02-20
1144786971 Andrew Hopkins Physician Assistant 489 State St, Bangor, ME 04401-6616 2019-02-18
1750847083 Daniel Patrick Conway Physician Assistant 489 State St, Bangor, ME 04401-6616 2019-02-12
1306317847 Matthew Daniel Kent Nurse Anesthetist, Certified Registered 489 State St, Bangor, ME 04401-6616 2018-12-10
1750869061 Brian Marsh Nurse Practitioner 489 State St, Bangor, ME 04401 2018-07-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184222523 Bj's Wholesale Club Inc. Eyewear Supplier (Equipment, not the service) 110 Longview Dr, Bangor, ME 04401 2020-10-16
1033737937 Daniel John Phulman Counselor 202 Exchange Street, Bangor, ME 04401 2020-07-08
1770104358 Elizabeth Sarah Caruson Physician Assistant 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 2020-05-05
1053961300 Erika Dean Occupational Therapist 84 Sylvan Rd., Bangor, ME 04401 2019-09-18
1942853635 Wildworks Therapy, Pllc Occupational Therapist 123 Mt Hope Ave, Bangor, ME 04401 2019-07-22
1255999173 Jessica Arbisi Physician Assistant 1 Northeast Drive, Bangor, ME 04401 2019-06-05
1699232041 Ehab Khamis Elhefnawi Anesthesiology Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 2019-02-21
1477028884 Zvorufura Makura Otolaryngology 885 Union Street, Ste 145, Bangor, ME 04401 2018-10-11
1255826541 Lindsey M Fields Optometrist 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 2018-06-28
1992211338 Debra J Mcintyre Counselor 157 Park Street, #5, Bangor, ME 04401 2017-12-21
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073139465 Jaclyn Kimberly Foraker Nurse Practitioner 885 Union St Ste 215, Bangor, ME 04401-3092 2020-06-22
1790326585 Remigiusz Mariusz Paluszak Nurse Practitioner 417 State St #400, Bangor, Me 04401, Bangor, MA 04401-0440 2019-10-02
1629594882 Auteum Lake Nurse Practitioner 277 State St Ste 1b, Bangor, ME 04401-5440 2017-08-19
1659730323 Cherie Christopherson Nurse Practitioner 417 State St Ste 200, Bangor, ME 04401-6630 2016-02-23
1194060236 Lori M. Lipari Nurse Practitioner 50521 34th Ave, Bangor, MI 49013-9726 2012-11-30
1306107446 Theresa Marie Knowles Nurse Practitioner 103 Maine Ave, Bangor, ME 04401-4330 2012-06-05
1164594057 Amy Cotton Nurse Practitioner 885 Union Street, Suite 221, Bangor, ME 04402-0404 2006-11-15
1003901729 Nancy J Fishwick Nurse Practitioner 30 Mckinley St, Bangor, ME 04401-3830 2006-10-04
1528098316 Constance M Springer-tracy Nurse Practitioner 656 State Street, Bangor, ME 04401-5609 2006-07-04
1699715417 Claire J Mooney Nurse Practitioner 915 Union St, Bangor, ME 04401-8602 2006-06-08
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Competitor

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City BANGOR
Zip Code 04401

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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