Individual provider Active NPI

Brianne Kori Gagnon

  • Addiction (Substance Use Disorder) Registered Nurse
  • Bangor, ME
National Provider Identifier
1639090988
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
RN91484 Issued in ME
Practice address
689 Odlin Rd
Bangor, ME 04401-6709
Phone
(207) 404-3722
NPI assigned
Jul 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X RN91484 ME Primary

Addresses

Primary practice location

689 Odlin Rd
Bangor, ME 04401-6709

Mailing address

426 Main Rd
Milford, ME 04461-3227

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

NPI Registry JSON

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

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1639090988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MAIN RD",
            "city": "MILFORD",
            "state": "ME",
            "postal_code": "044613227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 ODLIN RD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016709",
            "telephone_number": "207-404-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "BRIANNE",
        "middle_name": "KORI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "RN91484",
            "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 Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.