MRS. CARMEN JEAN VAN DUSEN (NPI# 1457802530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457802530 |
Entity Type | Individual |
Full Name | MRS. CARMEN JEAN VAN DUSEN |
Credential | FNP |
Practice Address |
417 State St Suite 330 Bangor ME 04401-6630 |
Mailing Address |
43 Whiting Hill Rd Suite 300 Brewer ME 04412-1005 |
Practice Telephone | 2079739070 |
Mailing Telephone | 2079734011 |
Mailing Fax Number | 2079734832 |
Enumeration Date | 2016-10-24 |
Last Update Date | 2016-11-21 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP161127 | ME | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
417 STATE ST SUITE 330 |
City | BANGOR |
State | ME |
Zip Code | 04401-6630 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295731131 | David Lawrence Levy | Internal Medicine | 417 State St, Ste 321, Bangor, ME 04401-6638 | 2005-06-24 |
1891304473 | Kristina Lynn Leonard | Nurse Practitioner | 417 State St, Bangor, ME 04401-6630 | 2020-07-29 |
1528558830 | Kelli Megan Nicole Huth | Physician Assistant | 417 State St, Bangor, ME 04401-6630 | 2018-05-11 |
1770005670 | Caitlin Dombrowski | Psychologist | 417 State St, Bangor, ME 04401 | 2017-07-12 |
1497281844 | Jamie Hight | Physician Assistant | 417 State St, Webber East Suite 221, Bangor, ME 04401-6630 | 2017-05-04 |
1255871240 | Courtney Lee Taylor | Nurse Practitioner | 417 State St, Webber East, Suite 421, Bangor, ME 04401-6630 | 2017-02-24 |
1083153977 | Tyler Munro | Physician Assistant | 417 State St, Suite 340, Bangor, ME 04401 | 2017-02-13 |
1992187199 | Erin Borges | Physician Assistant | 417 State St, Webber West Suite 340, Bangor, ME 04401-6630 | 2015-06-24 |
1750789897 | Dahl Chase Diagnostic Services | Clinical Medical Laboratory | 417 State St, Suite 440, Bangor, ME 04401-6630 | 2014-12-05 |
1669870705 | Dahl Chase Pathology Assoc. | Pathology | 417 State St, Suite 439, Bangor, ME 04401-6630 | 2014-12-05 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
Find all providers in zip 04401 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073139465 | Jaclyn Kimberly Foraker | Nurse Practitioner | 885 Union St Ste 215, Bangor, ME 04401-3092 | 2020-06-22 |
1790326585 | Remigiusz Mariusz Paluszak | Nurse Practitioner | 417 State St #400, Bangor, Me 04401, Bangor, MA 04401-0440 | 2019-10-02 |
1629594882 | Auteum Lake | Nurse Practitioner | 277 State St Ste 1b, Bangor, ME 04401-5440 | 2017-08-19 |
1659730323 | Cherie Christopherson | Nurse Practitioner | 417 State St Ste 200, Bangor, ME 04401-6630 | 2016-02-23 |
1194060236 | Lori M. Lipari | Nurse Practitioner | 50521 34th Ave, Bangor, MI 49013-9726 | 2012-11-30 |
1306107446 | Theresa Marie Knowles | Nurse Practitioner | 103 Maine Ave, Bangor, ME 04401-4330 | 2012-06-05 |
1164594057 | Amy Cotton | Nurse Practitioner | 885 Union Street, Suite 221, Bangor, ME 04402-0404 | 2006-11-15 |
1003901729 | Nancy J Fishwick | Nurse Practitioner | 30 Mckinley St, Bangor, ME 04401-3830 | 2006-10-04 |
1528098316 | Constance M Springer-tracy | Nurse Practitioner | 656 State Street, Bangor, ME 04401-5609 | 2006-07-04 |
1699715417 | Claire J Mooney | Nurse Practitioner | 915 Union St, Bangor, ME 04401-8602 | 2006-06-08 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.