Provider Demographics
NPI:1841010139
Name:CHICKADEE HEALTHCARE PLLC
Entity type:Organization
Organization Name:CHICKADEE HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAWHINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:WHNP
Authorized Official - Phone:207-212-1448
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 1:169 SOUTH RD STE 2
Practice Address - Street 2:
Practice Address - City:READFIELD
Practice Address - State:ME
Practice Address - Zip Code:04355-3340
Practice Address - Country:US
Practice Address - Phone:207-500-6285
Practice Address - Fax:877-497-0102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-12
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty