Provider Demographics
NPI:1487710505
Name:AINSWORTH, ALLISON MINA FREEMAN (NP)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:MINA FREEMAN
Last Name:AINSWORTH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-0040
Mailing Address - Country:US
Mailing Address - Phone:508-776-7018
Mailing Address - Fax:
Practice Address - Street 1:11 HARMONY LN
Practice Address - Street 2:
Practice Address - City:FORT FAIRFIELD
Practice Address - State:ME
Practice Address - Zip Code:04742-3354
Practice Address - Country:US
Practice Address - Phone:207-472-0590
Practice Address - Fax:207-472-0597
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251949363LA2200X
MECNP111118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health