KATHERINE A DICONZO


Address: 335 Brighton Ave, Portland, ME 04102
Phone: 2077754000

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
CNP181035 ME Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 335 BRIGHTON AVE
City PORTLAND
State ME
Zip Code 04102

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
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Competitor

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City PORTLAND
Zip Code 04102

Improve Information

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Dataset Information

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.

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