Provider Demographics
NPI:1427168400
Name:MATHURIN, MELISSA A (NP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:MATHURIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8 JESSE ROBBINS RD STE E
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-7510
Mailing Address - Country:US
Mailing Address - Phone:207-492-4882
Mailing Address - Fax:207-255-7204
Practice Address - Street 1:8 JESSE ROBBINS RD STE E
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-7510
Practice Address - Country:US
Practice Address - Phone:207-492-4882
Practice Address - Fax:207-255-7204
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME201282363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health