Provider Demographics
NPI:1699852350
Name:MOESSWILDE, JOANNE MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:MARIE
Last Name:MOESSWILDE
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 1:116 NORTHPORT AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6095
Mailing Address - Country:US
Mailing Address - Phone:207-930-6708
Mailing Address - Fax:207-930-6709
Practice Address - Street 1:116 NORTHPORT AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6095
Practice Address - Country:US
Practice Address - Phone:207-930-6708
Practice Address - Fax:207-930-6709
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81394363LF0000X
MER034891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME040698OtherANTHEM BC/BS
MES92474Medicare UPIN
MENP2062Medicare ID - Type Unspecified