Lateicia Theresa Pendergast, RN
Individual provider Active NPI Registered Nurse · Orrington, ME
NPI 1992615751 · NPPES record last updated Sep 11, 2026
Key facts
- NPI
- 1992615751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN76299 (ME)
- Practice address
- 8 Deer Run Dr
Orrington, ME 04474-3064 - Phone
- (207) 299-3530
- NPI assigned
- Sep 11, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2373864 | MA | |
| Registered Nurse | 163W00000X | RN76299 | ME | Yes |
Addresses
Primary practice location
8 Deer Run Dr
Orrington, ME 04474-3064
Mailing address
8 Deer Run Dr
Orrington, ME 04474-3064
Phone (207) 299-3530
Other providers in Orrington, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.