Provider Demographics
NPI:1790547388
Name:BROWN, ABIGAIL LYN (APRN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LYN
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:LYN
Other - Last Name:DAWBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8 SHAWMUT AVE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-3956
Mailing Address - Country:US
Mailing Address - Phone:774-277-0058
Mailing Address - Fax:
Practice Address - Street 1:1250 FOREST AVE STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-6403
Practice Address - Country:US
Practice Address - Phone:207-910-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP241016363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health