Provider Demographics
NPI:1730135039
Name:HAMEL CORSON, LOIS CATHERINE (ANP, PHD)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:CATHERINE
Last Name:HAMEL CORSON
Suffix:
Gender:F
Credentials:ANP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:ME
Mailing Address - Zip Code:04294-3600
Mailing Address - Country:US
Mailing Address - Phone:207-891-9547
Mailing Address - Fax:
Practice Address - Street 1:10 WATER ST STE 305
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6566
Practice Address - Country:US
Practice Address - Phone:207-660-9905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81088363LA2200X
MER030965163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME047792OtherBC/BS
ME265390099Medicaid
ME047792OtherBC/BS
ME265390099Medicaid