Provider Demographics
NPI:1629050992
Name:CHARETTE, MELISSA MARIE (APRN-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:CHARETTE
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 UNION ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6100
Mailing Address - Country:US
Mailing Address - Phone:207-316-9071
Mailing Address - Fax:207-433-1024
Practice Address - Street 1:175 UNION ST
Practice Address - Street 2:SUITE C
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6100
Practice Address - Country:US
Practice Address - Phone:207-316-9071
Practice Address - Fax:207-433-1024
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81160363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q01788Medicare UPIN