Provider Demographics
NPI:1235866336
Name:CREMONA, MEGAN MICHELLE (ACNP-AG)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MICHELLE
Last Name:CREMONA
Suffix:
Gender:F
Credentials:ACNP-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 NAPLES RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:ME
Mailing Address - Zip Code:04040-4404
Mailing Address - Country:US
Mailing Address - Phone:313-670-3043
Mailing Address - Fax:
Practice Address - Street 1:93 CAMPUS AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6030
Practice Address - Country:US
Practice Address - Phone:207-777-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP221241363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care