Provider Demographics
NPI:1528003266
Name:DAIGLE, BARBARA J (FNP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:DAIGLE
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 1:43 WHITING HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1006
Mailing Address - Country:US
Mailing Address - Phone:207-973-9595
Mailing Address - Fax:
Practice Address - Street 1:885 UNION ST
Practice Address - Street 2:SUITE 145
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3083
Practice Address - Country:US
Practice Address - Phone:207-973-9595
Practice Address - Fax:207-973-7898
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER039416363LF0000X
MECNP81419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME102380301Medicaid
ME102380200Medicaid
ME102380203Medicaid
ME102380302Medicaid
ME277290099Medicaid
ME203981Medicare ID - Type UnspecifiedMEDICARE A - BFM
ME102380301Medicaid
ME277290099Medicaid
ME102380203Medicaid
ME102380200Medicaid