Provider Demographics
NPI:1972265775
Name:DEANE, BONNIE ELAINE (PSS)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:ELAINE
Last Name:DEANE
Suffix:
Gender:F
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 SENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:ME
Mailing Address - Zip Code:04862-6214
Mailing Address - Country:US
Mailing Address - Phone:207-975-7801
Mailing Address - Fax:
Practice Address - Street 1:1879 SENNEBEC RD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:ME
Practice Address - Zip Code:04862-6214
Practice Address - Country:US
Practice Address - Phone:207-975-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
ME374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty