Individual provider Active NPI

Lisa Louise Letourneau-Bonn, P.N.P.

  • Pediatric Nurse Practitioner
  • Norway, ME
National Provider Identifier
1184013344
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CNP141080 Issued in ME
Practice address
193 Main St
Norway, ME 04268-5645
Phone
(207) 743-8766
Fax
(207) 393-3448
NPI assigned
Jan 12, 2015
Last updated
Jun 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X CNP141080 ME Primary

Addresses

Primary practice location

193 Main St
Norway, ME 04268-5645

Mailing address

159 Silver St
Waterville, ME 04901-5813
Phone (207) 873-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221206001920 ME Practitioner - Nurse Practitioner 1456720911 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP141080MEMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Dec 1, 2022 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Dec 1, 2022 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Current Accepting new patients
Waterville Pediatrics PA Past Accepting new patients

Locations

193 Main St
Norway, ME 04268
Phone (207) 743-2544

8 Pikes Hl
Norway, ME 04268
Phone (207) 743-9292

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Interoperability endpoints

  • Direct secure messaging: lletourneau127254@direct.mmc.mainehealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1184013344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 SILVER ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015813",
            "telephone_number": "207-873-5437",
            "fax_number": "207-861-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 MAIN ST",
            "city": "NORWAY",
            "state": "ME",
            "postal_code": "042685645",
            "telephone_number": "207-743-8766",
            "fax_number": "207-393-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETOURNEAU-BONN",
        "first_name": "LISA",
        "middle_name": "LOUISE",
        "credential": "P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ME",
            "license": "CNP141080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norway, ME

Sources for this page

Verify at the official NPI Registry.