Provider Demographics
NPI:1376045070
Name:CARDURNS, ASHLEY A (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:CARDURNS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1960
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-1960
Mailing Address - Country:US
Mailing Address - Phone:207-530-8090
Mailing Address - Fax:207-888-1033
Practice Address - Street 1:15 MOODY ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072
Practice Address - Country:US
Practice Address - Phone:207-530-8090
Practice Address - Fax:207-888-1033
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP181042363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECNP181042OtherMAINE LICENSE NUMBER