Provider Demographics
NPI:1598964405
Name:RACINE, JULIE A (PMH-NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:RACINE
Suffix:
Gender:F
Credentials:PMH-NP
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 158
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:ME
Mailing Address - Zip Code:04776-0158
Mailing Address - Country:US
Mailing Address - Phone:207-365-9932
Mailing Address - Fax:207-365-9933
Practice Address - Street 1:226 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:ME
Practice Address - Zip Code:04776-3064
Practice Address - Country:US
Practice Address - Phone:207-365-9932
Practice Address - Fax:207-433-1131
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP111013363LP0808X
MEAP111013363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty