MICHELLE LYN LACOMBE


Address: 360 Broadway, Bangor, ME 04401-3979
Phone: 2079073000

MICHELLE LYN LACOMBE (NPI# 1952732265) 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) 1952732265
Entity Type Individual
Full Name MICHELLE LYN LACOMBE
Other Name MICHELLE LYN LACOMBE
Credential PMH-NP
Practice Address 360 Broadway
Bangor
ME 04401-3979
Mailing Address C/o St Marys Health System - Provider Enrollment
Po Box 7291
Lewiston
ME 04243-7291
Practice Telephone 2079073000
Practice Fax Number 2079071921
Mailing Telephone 2077778560
Mailing Fax Number 2077778800
Enumeration Date 2013-12-12
Last Update Date 2020-10-20
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
CNP131112 ME Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
360 Broadway, Bangor, ME 044013979 2079073000 2079071921
735 Wilson St, Brewer Medical Center, Brewer, ME 044121000 2079891567

Office Location

Street Address 360 BROADWAY
City BANGOR
State ME
Zip Code 04401-3979

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154321545 St. Joseph Hospital General Acute Care Hospital 360 Broadway, Bangor, ME 04401-3979 2005-07-28
1346802170 Sadie Austin Physician Assistant 360 Broadway, Bangor, ME 04401-3900 2019-07-02
1386202794 Ashley Gott Haase Physical Therapist 360 Broadway, Bangor, ME 04401-3979 2019-05-31
1992286546 Royce Blackwood Physician Assistant 360 Broadway, Bangor, ME 04401-3979 2018-08-22
1609356559 Casey Marie Northup Pharmacy Technician 360 Broadway, Bangor, ME 04401-3900 2018-08-20
1407332869 Sara Winings Pharmacist 360 Broadway, Bangor, ME 04401-3979 2018-07-18
1811489156 Sandra Bartlett Pharmacist 360 Broadway, Bangor, ME 04401-3979 2018-06-02
1366999534 Eliza Sharma Internal Medicine 360 Broadway, Bangor, ME 04401-3900 2016-09-06
1871946731 Katelyn Hopper Anesthesiology 360 Broadway, Bangor, ME 04401-3979 2016-07-15
1790139459 Stephen Calabrese Anesthesiology 360 Broadway, Bangor, ME 04401-3979 2016-04-19
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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 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770828857 Carlarae Jean Peavey-mitchell Nurse Practitioner 268 Stillwater Ave # 422, Bangor, ME 04401-3945 2012-11-30
1326319716 Rachel Audrey Booker Nurse Practitioner 42 Cedar St., Bangor, ME 04402 2012-01-18
1518236306 Moving Forward Mental Health Services Nurse Practitioner 61 Main St Ste 53, Bangor, ME 04401-6333 2011-12-22
1407976772 Deborah L Maclean Nurse Practitioner 179 Indiana Avenue, Bangor, ME 04401 2007-03-30
1356476436 Nancy J Grover Nurse Practitioner 42 Cedar Street, Bangor, ME 04402-0425 2007-02-22
1114009990 Diane F Ouellette Nurse Practitioner 1012 Union St., Bangor, ME 04401 2006-10-20
1497847065 Virginia M Merrill Nurse Practitioner 42 Cedar St, Community Health and Counseling Services, Bangor, ME 04401-6433 2006-09-29
1629050992 Melissa Marie Charette Nurse Practitioner 175 Union St, Suite C, Bangor, ME 04401-6100 2005-11-14
1407457898 Shannon Cook Nurse Practitioner 268 Stillwater Ave, Bangor, ME 04401-3945 2020-11-03
1013515477 Crystle Eldridge Nurse Practitioner 268 Stillwater Ave, Bangor, ME 04401-3945 2020-10-16
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Competitor

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City BANGOR
Zip Code 04401

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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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