Active NPI
Mary Kay Deighan, R.N.
- Plastic Surgery Registered Nurse
- Bangor, ME
National Provider Identifier
1194058552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Registered Nurse
- License
- 025296
- Practice address
- 55 Broadway
Bangor, ME 04401-5201 - Phone
- (207) 947-5657
- Fax
- (207) 947-1894
- NPI assigned
- Sep 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Registered Nurse | 163WS0121X | 025296 | ME | Primary |
Addresses
Primary practice location
55 Broadway
Bangor, ME 04401-5201
Mailing address
55 Broadway
Bangor, ME 04401-5201
Phone (207) 947-5657
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025296 | ME | MD | Plastic Surgery Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1194058552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 BROADWAY",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015201",
"telephone_number": "207-947-5657",
"fax_number": "207-947-1894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 BROADWAY",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015201",
"telephone_number": "207-947-5657",
"fax_number": "207-947-1894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEIGHAN",
"first_name": "MARY KAY",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-16",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0121X",
"taxonomy_group": "",
"desc": "Registered Nurse, Plastic Surgery",
"state": "ME",
"license": "025296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.