Provider Demographics
NPI:1699739409
Name:SCHLEMANN, ANITA J (APRN BC)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:J
Last Name:SCHLEMANN
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:MS
Other - First Name:ANITA
Other - Middle Name:JEAN
Other - Last Name:SCHLEMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN,BC
Mailing Address - Street 1:100 FODEN ROAD WEST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106
Mailing Address - Country:US
Mailing Address - Phone:207-874-1488
Mailing Address - Fax:207-523-8593
Practice Address - Street 1:100 FODEN RD, WEST
Practice Address - Street 2:SUITE 203
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2327
Practice Address - Country:US
Practice Address - Phone:207-828-0361
Practice Address - Fax:207-874-1483
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME021481364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MENS8046Medicare ID - Type Unspecified
MENS804601Medicare PIN