Sandra J Picard, NP

Individual provider Active NPI Family Nurse Practitioner · Manchester, ME

NPI 1528034592 · NPPES record last updated Jan 15, 2013

Key facts

NPI
1528034592
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
CNP81277 (ME)
Practice address
8 Pond Rd
Manchester, ME 04351-3615
Phone
(207) 512-8780
Fax
(207) 623-3137
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

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

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
CNP81277MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthreach Community Health Centers Past Accepting new patients
Healthreach Community Health Centers Past Accepting new patients
Healthreach Community Health Centers Past
since Dec 27, 1991
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP81277 ME Yes

Addresses

Primary practice location

8 Pond Rd
Manchester, ME 04351-3615

Mailing address

31 Readfield Unit 558
Manchester, ME 04351-0558
Phone (207) 512-8780

Other identifiers

IdentifierTypeStateIssuer
241890099MedicaidME

Other providers in Manchester, ME

All providers in Manchester, ME · Family Nurse Practitioner in Maine

Sources for this page

Verify at the official NPI Registry.