Provider Demographics
NPI:1962293027
Name:GREENWOOD, MICHAELLA ELIZABETH (FNP)
Entity type:Individual
Prefix:
First Name:MICHAELLA
Middle Name:ELIZABETH
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE JUNCTION
Mailing Address - State:ME
Mailing Address - Zip Code:04442-0295
Mailing Address - Country:US
Mailing Address - Phone:207-280-0259
Mailing Address - Fax:
Practice Address - Street 1:891 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426-1059
Practice Address - Country:US
Practice Address - Phone:207-564-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP251164363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care