Provider Demographics
NPI:1568820264
Name:SWEETSER, MICHELLE (FNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SWEETSER
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 1:4 CLEMENT WAY
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:ME
Mailing Address - Zip Code:04917-4370
Mailing Address - Country:US
Mailing Address - Phone:207-495-3323
Mailing Address - Fax:207-495-3353
Practice Address - Street 1:4 CLEMENT WAY
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:ME
Practice Address - Zip Code:04917-4370
Practice Address - Country:US
Practice Address - Phone:207-495-3323
Practice Address - Fax:207-495-3353
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN54927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily