Provider Demographics
NPI:1326610551
Name:PICKOSKI-CAPUANO, MICHELLE F (FNPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:F
Last Name:PICKOSKI-CAPUANO
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:PICKOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNPC
Mailing Address - Street 1:915 UNION ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-8602
Mailing Address - Country:US
Mailing Address - Phone:207-973-8030
Mailing Address - Fax:
Practice Address - Street 1:915 UNION ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-8602
Practice Address - Country:US
Practice Address - Phone:207-973-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP211232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily