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 | 2084N0402X | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology | | | No |
| 2 | 2084N0600X | Psychiatry & Neurology | Clinical Neurophysiology | | | No |
| 3 | 2084P2900X | Psychiatry & Neurology | Pain Medicine | | | No |
| 4 | 2084V0102X | Psychiatry & Neurology | Vascular Neurology | | | No |
| 5 | 2471M1202X | Radiologic Technologist | Magnetic Resonance Imaging | | | No |
| 6 | 282N00000X | General Acute Care Hospital | | 37563 | MAINE | No |
| 7 | 363LA2200X | Nurse Practitioner | Adult Health | | | No |
| 8 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 9 | 363LP0200X | Nurse Practitioner | Pediatrics | | | No |
| 10 | 2084N0400X | Psychiatry & Neurology | Neurology | | | Yes |