Provider Demographics
NPI:1093843252
Name:PILESKI, ELLEN (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:PILESKI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 CAMDEN RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04849-6025
Mailing Address - Country:US
Mailing Address - Phone:207-230-4891
Mailing Address - Fax:
Practice Address - Street 1:119 NORTHPORT AVE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6069
Practice Address - Country:US
Practice Address - Phone:207-505-4567
Practice Address - Fax:207-536-2794
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEQ40226Medicare UPIN