Provider Demographics
NPI:1699922492
Name:ABERNETHY, JOSELYN M (MSN, ACNP-BC)
Entity type:Individual
Prefix:
First Name:JOSELYN
Middle Name:M
Last Name:ABERNETHY
Suffix:
Gender:F
Credentials:MSN, ACNP-BC
Other - Prefix:
Other - First Name:JOSELYN
Other - Middle Name:M
Other - Last Name:CORTEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, ACNP-BC
Mailing Address - Street 1:10 ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-1954
Mailing Address - Country:US
Mailing Address - Phone:207-761-6642
Mailing Address - Fax:
Practice Address - Street 1:10 ANDOVER RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-1954
Practice Address - Country:US
Practice Address - Phone:207-761-6642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN78698163W00000X
CT003871363L00000X
VT101.0102069363LA2100X
NYF431307-1363LA2100X
NY431307363LA2100X
OHCOA.10782-NP363LA2100X
MECNP211086363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECNP211086OtherSTATE LICENSURE
OHCOA.10782-NPOtherSTATE LICENSURE
VT101.0102069OtherSTATE LICENSURE
NY43107OtherSTATE LICENSURE