Provider Demographics
NPI:1912013442
Name:GRANGE, CLAUDINE NANCY WILHELMI (PMHNP)
Entity type:Individual
Prefix:MS
First Name:CLAUDINE
Middle Name:NANCY WILHELMI
Last Name:GRANGE
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:CLAUDINE
Other - Middle Name:NANCY
Other - Last Name:WILHELMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3719
Mailing Address - Country:US
Mailing Address - Phone:207-874-6777
Mailing Address - Fax:
Practice Address - Street 1:95 PINE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3719
Practice Address - Country:US
Practice Address - Phone:207-874-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81848363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health