Provider Demographics
NPI:1609526672
Name:LESSARD, AMY DOREEN (LPN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DOREEN
Last Name:LESSARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:D
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:40 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4524
Mailing Address - Country:US
Mailing Address - Phone:207-872-7272
Mailing Address - Fax:207-872-0639
Practice Address - Street 1:40 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4524
Practice Address - Country:US
Practice Address - Phone:207-872-7272
Practice Address - Fax:207-872-0639
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN36541163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse