Provider Demographics
NPI:1043922610
Name:PLANSON, ANTONINA
Entity type:Individual
Prefix:
First Name:ANTONINA
Middle Name:
Last Name:PLANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 COMMERCE PLZ
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-1498
Mailing Address - Country:US
Mailing Address - Phone:207-624-3800
Mailing Address - Fax:207-624-3845
Practice Address - Street 1:16 COMMERCE PLZ
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364-1498
Practice Address - Country:US
Practice Address - Phone:207-624-3800
Practice Address - Fax:207-624-3845
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP221567363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily