KATHERINE A DICONZO (NPI# 1700380466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700380466 |
Entity Type | Individual |
Full Name | KATHERINE A DICONZO |
Credential | APRN-CNP |
Practice Address |
335 Brighton Ave Portland ME 04102 |
Mailing Address |
Po Box 1849 Lewiston ME 04241-1849 |
Practice Telephone | 2077754000 |
Mailing Telephone | 2077842554 |
Mailing Fax Number | 2077771439 |
Enumeration Date | 2018-03-19 |
Last Update Date | 2018-03-19 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP181035 | ME | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
335 BRIGHTON AVE |
City | PORTLAND |
State | ME |
Zip Code | 04102 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174515720 | Raymond R White | Orthopaedic Surgery | 335 Brighton Ave, Suite 200, Portland, ME 04103-2362 | 2005-08-19 |
1619519873 | Maine Medical Consultants PC | Internal Medicine | 335 Brighton Ave, Portland, ME 04102-2363 | 2019-10-09 |
1972085140 | Regina M Bowie | Registered Nurse | 335 Brighton Ave, Portland, ME 04102-2363 | 2018-09-04 |
1780170431 | Kayla Marlise Heins | Speech-Language Pathologist | 335 Brighton Ave, Portland, ME 04102-2363 | 2018-07-05 |
1316471105 | Deborah Mcginnis | Occupational Therapist | 335 Brighton Ave, Portland, ME 04102-2363 | 2017-04-18 |
1811435100 | Andrew F Scichilone | Physician Assistant | 335 Brighton Ave, Suite 200, Portland, ME 04102-2363 | 2017-02-07 |
1134572316 | Physical and Functional Medicine Incorporated | Physical Medicine & Rehabilitation | 335 Brighton Ave, Portland, ME 04102-2363 | 2016-07-22 |
1710362421 | Joel P Miller | Physician Assistant | 335 Brighton Ave, Portland, ME 04102-2363 | 2015-07-23 |
1447646260 | Zachary Cohn | Student in an Organized Health Care Education/Training Program | 335 Brighton Ave, Portland, ME 04102-2363 | 2015-04-08 |
1194166835 | Alison Hastings Traver | Physician Assistant | 335 Brighton Ave, Portland, ME 04102-2363 | 2013-07-10 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
Find all providers in zip 04102 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
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1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
Find all providers in PORTLAND |
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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.