LISA L BULTHUIS NP NPI 1689636607

NPI Information

NPI: 1689636607
Provider Name: LISA L BULTHUIS, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
100 FODEN RD, WEST
SUITE 100
SOUTH PORTLAND, ME
ZIP 04106
Phone: (207) 523-3904
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Lisa L Bulthuis, NP is a family nurse practitioner in South Portland, ME with 25 years of experience. Lisa L Bulthuis, NP NPI is 1689636607. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

100 FODEN RD, WEST
SUITE 100
SOUTH PORTLAND, ME
ZIP 04106
Phone: (207) 523-3904
Fax: (207) 523-8588

The NPI 1689636607 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 11/7/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	CNP81553	MAINE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E400409706	OTHER	MAINE	MEDICARE
2	NP271203	MEDICARE PIN	MAINE
3	NP271202	MEDICARE PIN	MAINE
4	E400409710	OTHER	MAINE	MEDICARE
5	E400229846	MEDICARE PIN	MAINE
6	NP271201	MEDICARE PIN	MAINE
7	NP2712	MEDICARE PIN	MAINE
8	P15445	MEDICARE UPIN	MAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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