Individual provider Active NPI

Nicole Henson, AGAC-NP

  • Acute Care Nurse Practitioner
  • Lewiston, ME
National Provider Identifier
1689592016
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
CNP261344 Issued in ME
Practice address
15 Strawberry Ave
Lewiston, ME 04240-5941
Phone
(207) 777-7740
NPI assigned
Jul 6, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X CNP261344 ME Primary

Addresses

Primary practice location

15 Strawberry Ave
Lewiston, ME 04240-5941

Mailing address

362 Crowley Rd
Sabattus, ME 04280-4608
Phone (207) 312-1225

Medicare participation

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

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": "1783296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1689592016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 CROWLEY RD",
            "city": "SABATTUS",
            "state": "ME",
            "postal_code": "042804608",
            "telephone_number": "207-312-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 STRAWBERRY AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405941",
            "telephone_number": "207-777-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "NICOLE",
        "credential": "AGAC-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-06",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ME",
            "license": "CNP261344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.