Provider Demographics
NPI:1063590362
Name:GAUSE, PHOEBE PAINE (FNP)
Entity type:Individual
Prefix:MS
First Name:PHOEBE
Middle Name:PAINE
Last Name:GAUSE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 STATE ST.
Mailing Address - Street 2:SURGICAL NAVIGATION DEPT.
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-973-9642
Mailing Address - Fax:207-973-4371
Practice Address - Street 1:489 STATE ST.
Practice Address - Street 2:SURGICAL NAVIGATION DEPT.
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-973-9642
Practice Address - Fax:207-973-4371
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER40186363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily