Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Amanda Ann Theriault, APRN-CNP

Individual provider Adult Health Nurse Practitioner · NPI 1548997521

Amanda Ann Theriault, APRN-CNP is a Nurse Practitioner in Bangor, Maine. Qualified in 2022, 4 years ago. Practices with Northeast Nephrology PA, a 6-clinician group and accepts Medicare assignment. Licensed in Maine.

Years since qualifying
4
Licensed in
ME
In the registry since
2022

Practice location Address checks out

417 State St Ste 321
Bangor, ME 04401-6638
Phone: (207) 973-8833
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence CNP221315 (ME)

Record details

NPI number1548997521
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-CNP
Sole proprietorNo
NPI enumeratedAugust 1, 2022
Last updated in NPPESAugust 1, 2022
Certification dateAugust 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Northeast Nephrology Pa — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Bangor