Provider Demographics
NPI:1225829617
Name:BOURGOIN, CARYN DELIA (NP)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:DELIA
Last Name:BOURGOIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:
Other - Last Name:DEMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8 PIKES HL
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:ME
Mailing Address - Zip Code:04268-5340
Mailing Address - Country:US
Mailing Address - Phone:207-744-6444
Mailing Address - Fax:207-743-6306
Practice Address - Street 1:8 PIKES HL
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5340
Practice Address - Country:US
Practice Address - Phone:207-744-6444
Practice Address - Fax:207-743-6306
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN40036163W00000X
MECNP251368363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse