Provider Demographics
NPI:1881684264
Name:MILLES, CYNTHIA L (FNP, PHD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:MILLES
Suffix:
Gender:F
Credentials:FNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 FOGGY RIDGE LN
Mailing Address - Street 2:PO BOX 97
Mailing Address - City:ORRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04474
Mailing Address - Country:US
Mailing Address - Phone:207-249-5405
Mailing Address - Fax:
Practice Address - Street 1:900 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-1900
Practice Address - Country:US
Practice Address - Phone:207-907-3300
Practice Address - Fax:207-907-1923
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME246430099Medicaid
MES50263Medicare UPIN
ME246430099Medicaid
NP0938Medicare PIN