Provider Demographics
NPI:1508632183
Name:LEPAGE, MAUREEN PATRICIA (ACNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:PATRICIA
Last Name:LEPAGE
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:PATRICIA
Other - Last Name:GIBBONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:181 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6144
Mailing Address - Country:US
Mailing Address - Phone:207-779-3120
Mailing Address - Fax:207-779-2901
Practice Address - Street 1:181 FRANKLIN HEALTH CMNS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6144
Practice Address - Country:US
Practice Address - Phone:207-779-3120
Practice Address - Fax:207-779-2901
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP231587363LA2200X, 363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology