Provider Demographics
NPI:1245093848
Name:BEAULIER, MOLLIE L (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:MOLLIE
Middle Name:L
Last Name:BEAULIER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:MOLLIE
Other - Middle Name:L
Other - Last Name:BURR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:615 KENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-3020
Mailing Address - Country:US
Mailing Address - Phone:207-356-6726
Mailing Address - Fax:
Practice Address - Street 1:489 STATE ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6616
Practice Address - Country:US
Practice Address - Phone:207-973-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP231672363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care