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NPI Code Detail

MEDICARE: KAIJA FELLMAN LOPEZ RN

MEDICARE: KAIJA FELLMAN LOPEZ RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN84796ME

General Provider Information

NPI Number : 1760346381
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAIJA FELLMAN LOPEZ RN
Provider Business Mailing Address
First Line : 17 HIGH ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7614
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17 HIGH ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7614
Country : US
Telephone Number : 207-795-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ KAIJA FELLMAN LOPEZ RN” Practice Location

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