Provider Demographics
NPI:1295524932
Name:CADORETTE, RYAN JOSEPH (ACNPC-AG)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JOSEPH
Last Name:CADORETTE
Suffix:
Gender:M
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HEALTHCARE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9445
Mailing Address - Country:US
Mailing Address - Phone:207-282-3666
Mailing Address - Fax:207-294-3552
Practice Address - Street 1:9 HEALTHCARE DR STE 105
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9445
Practice Address - Country:US
Practice Address - Phone:207-282-3666
Practice Address - Fax:207-294-3552
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP241190363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology