Provider Demographics
NPI:1558855049
Name:MAWHINNEY, LEAH MARIE (CNP, CNM)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:MARIE
Last Name:MAWHINNEY
Suffix:
Gender:F
Credentials:CNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 S TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:ME
Mailing Address - Zip Code:04352-3354
Mailing Address - Country:US
Mailing Address - Phone:207-212-1448
Mailing Address - Fax:
Practice Address - Street 1:700 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6800
Practice Address - Country:US
Practice Address - Phone:888-731-8994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNM212012367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECNM212012OtherSTATE LICENSE