Provider Demographics
NPI:1225829617
Name:BOURGOIN, CARYN
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:BOURGOIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:
Other - Last Name:DEMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:280 TRAPP RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-8628
Mailing Address - Country:US
Mailing Address - Phone:207-240-3252
Mailing Address - Fax:
Practice Address - Street 1:280 TRAPP RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-8628
Practice Address - Country:US
Practice Address - Phone:207-240-3252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN40036163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse