Provider Demographics
NPI:1902532575
Name:DIONNE, RACHEL A (AGACNP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:A
Last Name:DIONNE
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:STOREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 LINDA ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04021-4016
Mailing Address - Country:US
Mailing Address - Phone:207-615-9989
Mailing Address - Fax:
Practice Address - Street 1:22 BRAMHALL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3175
Practice Address - Country:US
Practice Address - Phone:207-662-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP221370363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECNP221370OtherNURSE PRACTITIONER LICENSE