Provider Demographics
NPI:1528224177
Name:GIGNOUX, WENDY Z (FNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:Z
Last Name:GIGNOUX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 UNION ST
Mailing Address - Street 2:MAINE COAST MEMORIAL HOSPITAL
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1586
Mailing Address - Country:US
Mailing Address - Phone:207-664-5304
Mailing Address - Fax:207-664-5305
Practice Address - Street 1:37 CLINIC RD
Practice Address - Street 2:ELEANOR WIDENER DIXON MEMORIAL CLINIC
Practice Address - City:GOULDSBORO
Practice Address - State:ME
Practice Address - Zip Code:04607-4013
Practice Address - Country:US
Practice Address - Phone:207-963-4066
Practice Address - Fax:207-963-7723
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER025584363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MENP144001Medicare PIN
MENP144002Medicare PIN