Provider Demographics
NPI:1912780040
Name:PLESSNER, ELIZABETH ROSE PEDERSEN (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROSE PEDERSEN
Last Name:PLESSNER
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ROSE
Other - Last Name:PEDERSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3077 KENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:ME
Mailing Address - Zip Code:04444-4956
Mailing Address - Country:US
Mailing Address - Phone:207-478-5038
Mailing Address - Fax:
Practice Address - Street 1:489 STATE STREET
Practice Address - Street 2:KAGAN BUILDING #2 NL EMMC
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-973-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP2313732086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery