Brenda Bennett-Vachon, PMHNP

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Auburn, ME

NPI 1407904014 · NPPES record last updated Dec 3, 2020

Key facts

NPI
1407904014
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
CNP81162 (ME)
Practice address
153 Woodbury Rd
Auburn, ME 04210-8136
Phone
(207) 784-4301
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP081162MEMDPsychiatric/Mental Health Nurse Practitioner
CNP81162MEMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP81162 ME Yes
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP081162 ME

Addresses

Primary practice location

153 Woodbury Rd
Auburn, ME 04210-8136

Mailing address

153 Woodbury Rd
Auburn, ME 04210-8136
Phone (207) 784-4301

Other identifiers

IdentifierTypeStateIssuer
424300099MedicaidME

Other providers in Auburn, ME

All providers in Auburn, ME · Psychiatric/Mental Health Nurse Practitioner in Maine

Sources for this page

Verify at the official NPI Registry.