Provider Demographics
NPI:1588850317
Name:LUFKIN-CURTIS, SUSAN J (MSN, FNP-C, CNM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:LUFKIN-CURTIS
Suffix:
Gender:F
Credentials:MSN, FNP-C, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 STILLWATER AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3984
Mailing Address - Country:US
Mailing Address - Phone:207-945-6588
Mailing Address - Fax:207-945-2955
Practice Address - Street 1:12 STILLWATER AVE STE 1
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3984
Practice Address - Country:US
Practice Address - Phone:207-945-6588
Practice Address - Fax:207-945-2955
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC001773367A00000X
MEAP081860363LF0000X
MEAM112004367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
11784005OtherCAQH
MDAC001773OtherMARYLAND LICENSE
F0707368OtherAANP
MER036648OtherLICENSE