Provider Demographics
NPI:1417130089
Name:MUELLER, ANNETTE BONNIE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:BONNIE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:ANNETTE
Other - Middle Name:BONNIE
Other - Last Name:CASWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC FAMILY NURSE
Mailing Address - Street 1:16 CUMBERLAND WAY
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074
Mailing Address - Country:US
Mailing Address - Phone:617-281-1575
Mailing Address - Fax:207-947-0435
Practice Address - Street 1:202 US ROUTE 1, SUITE 200
Practice Address - Street 2:TRUE NORTH HEALTH CENTER
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105
Practice Address - Country:US
Practice Address - Phone:207-781-4488
Practice Address - Fax:207-781-4470
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9263967363LF0000X
MEAP101009363LF0000X
MECNP101009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAI109ZMedicare PIN