Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tina Marie Blackley, APRNFNP-C

Individual provider Family Nurse Practitioner · NPI 1962937417

Tina Marie Blackley, APRNFNP-C is a Nurse Practitioner in Bangor, Maine. Qualified in 2017, 9 years ago. Practices with Penobscot Indian Nation Finance Office, a 9-clinician group and accepts Medicare assignment. Licensed in Maine.

Years since qualifying
9
Licensed in
ME
In the registry since
2017
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Practice location Address checks out

900 Broadway
Bangor, ME 04401
Phone: (207) 907-3300
Fax: (207) 907-1923
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence CNP171038 (ME)

Record details

NPI number1962937417
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRNFNP-C
Sole proprietorNo
NPI enumeratedApril 21, 2017
Last updated in NPPESDecember 6, 2019

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Penobscot Indian Nation Finance Office — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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