Provider Demographics
NPI:1528474186
Name:PELLETIER, HANA JOYCE (APRN-BC)
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:JOYCE
Last Name:PELLETIER
Suffix:
Gender:F
Credentials:APRN-BC
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 63
Mailing Address - Street 2:
Mailing Address - City:BRYANT POND
Mailing Address - State:ME
Mailing Address - Zip Code:04219-0063
Mailing Address - Country:US
Mailing Address - Phone:207-743-7721
Mailing Address - Fax:
Practice Address - Street 1:193 MAIN STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268
Practice Address - Country:US
Practice Address - Phone:207-743-7721
Practice Address - Fax:207-743-6306
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP141076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily