Lynn M Bolduc, MS, RD,LD,CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D1517 Issued in ME

Practice address

905 Union St
Suite 11
Bangor, ME 04401-3050

Phone

(207) 973-7334

Fax

(207) 973-7424

NPI assigned

Jul 21, 2006

Last updated

Jul 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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

• Norumbega Medical Specialists, LTD

  • Health Service Clinic/Center
  • Brewer, ME
  • NPI 1780821140
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1902827207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL",
            "address_2": "SUITE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "04412",
            "telephone_number": "207-973-7334",
            "fax_number": "207-973-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 UNION ST",
            "address_2": "SUITE 11",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013050",
            "telephone_number": "207-973-7334",
            "fax_number": "207-973-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDUC",
        "first_name": "LYNN",
        "middle_name": "M",
        "credential": "MS, RD,LD,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "D1517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ann Bodkin, LCSW
• Ronald Nicholas Bogdasarian, MD
• Lola C. Bogyo, PH.D.
• Penny Bohac-Cardello, LCPC
• Nicholas Boissoneault, PT
• Reilly Autumn Bolin, FNP
• Elizabeth Bollenbacher, DO
• Larry P Bolster, LCSW
• Meridith Bolster, LCSW
• Lisa Marie Boma, NP

• Registered Dietitian in Bangor, ME
• Providers in Bangor, ME by specialty
• Registered Dietitian in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; 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.