IndividualActive
Brandi Nickerson, PA-C
NPI 1083164933 · Medical Physician Assistant · Bangor, ME
Provider details
- NPI number
- 1083164933
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA1652 (ME)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1 Northeast Dr
Bangor, ME 04401-4332
Phone: (207) 275-3800
Approximate (ZIP-level) locationGet directions
Mailing address
43 Whiting Hill Rd Ste 300
Brewer, ME 04412-1006
Registry dates
- Enumerated
- 2016-10-04
- Last updated
- 2026-02-19
- Certified
- 2026-02-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.