Individual provider · NPI-1

Rachael Menius Burgess, MSN, CPNP-AC, CPON

Nurse Practitioner, Pediatrics · Portland, ME

NPI number1174963136
StatusActive
Last updated in NPPESAug 13, 2019

Details

NPI
1174963136
Entity type
Individual (NPI-1)
Name
Rachael Menius Burgess
Credential
MSN, CPNP-AC, CPON
Sex
Female
Sole proprietor
No
Enumeration date
Jul 4, 2013
Last updated
Aug 13, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsCNP191176MEYes
163W00000X Registered NurseRN632009PA
163W00000X Registered NurseRN2281692MA
363LP0200X Nurse Practitioner, PediatricsRN2281692MA

Practice location

22 Bramhall St
Portland, ME 04102-3134

Phone 207-662-3500

Mailing address

22 Bramhall St
Portland, ME 04102-3134

Phone 207-662-3500

Other practice locations

450 Brookline Ave
D-2078
Boston, MA 02215-5418

Phone 617-632-5436

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